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Cénat JM, Moshirian Farahi SMM, Broussard C, Dalexis RD. The state of COVID-19 vaccine confidence and need in Black individuals in Canada: Understanding the role of sociodemographic factors, health literacy, conspiracy theories, traumatic stressors and racial discrimination. Vaccine 2024; 42:960-968. [PMID: 37891050 DOI: 10.1016/j.vaccine.2023.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Black communities in Canada have been among the most affected by the COVID-19 pandemic, in terms of number of infections and deaths. They are also among those most hesitant about vaccination against COVID-19. However, while a few studies have documented the factors associated with COVID-19 vaccine hesitancy, those related to vaccine confidence remain unknown. To respond to this gap, this study aims to investigate factors associated to vaccine confidence in Black individuals in Canada. METHODS A total of 2002 participants (1034 women) aged 14 to 89 years old (Mean age = 29.34, SD = 10.13) completed questionnaires assessing sociodemographic information, COVID-19 vaccine confidence and need, health literacy, conspiracy beliefs, major racial discrimination, and traumatic stressors related to COVID-19. RESULTS Results showed an average score of COVID-19 vaccine confidence and need of 33.27 (SD = 7.24), with no significant difference between men (33.48; SD = 7.24) and women (33.08; SD = 7.91), t (1999) = 1.19, p = 0.234. However, there were significant differences according to employment status, migration status, age, inhabited province, spoken language, education, marital status, religion, and income. The linear regression model explained 25.8 % of the variance and showed that health literacy (B = 0.12, p < 0.001) and traumatic stressors related to COVID-19 (B = 0.21, p < .001) predicted COVID-19 vaccine confidence and need positively, while conspiracy beliefs (B = -1.14, p < 0.001) and major racial discrimination (B = -0.20, p = 0.044) predicted it negatively. CONCLUSIONS This study showed that building the confidence of Black communities in vaccines requires health education, elimination of racial discrimination in the Canadian society and a focus on certain groups (e.g., young people, those living in Quebec and Ontario). The results also argue in favor of involving community leaders and organizations in the development and implementation of vaccination-related tools, strategies and programs by city, provincial and federal public health agencies.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | | | - Cathy Broussard
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Population Health, University of Ottawa, Ottawa, Ontario, Canada
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Cénat JM, Farahi SMMM, Dalexis RD, Yaya S, Caulley L, Chomienne MH. COVID-19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID-19 stress as mediators. J Med Virol 2024; 96:e29467. [PMID: 38348886 DOI: 10.1002/jmv.29467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/15/2024]
Abstract
Factors influencing vaccine uptake in Black individuals remain insufficiently documented. Understanding the role of COVID-19 related stress, conspiracy theories, health literacy, racial discrimination experiences, and confidence in health authorities can inform programs to increase vaccination coverage. We sought to analyze these factors and vaccine uptake among Black individuals in Canada. A representative sample of 2002 Black individuals from Ontario, Quebec, Alberta, Nova Scotia, New Brunswick, British Columbia, and Manitoba, aged 14 years or older completed questionnaires assessing vaccine uptake, health literacy, conspiracy theories, racial discrimination experiences, COVID-19-related stress, and confidence in health authorities. Mediation analyses were conducted to assess (1) the effect of health literacy on COVID-19 vaccination uptake through confidence and need, COVID-19 related traumatic stress, and racial discrimination, and (2) the effect of conspiracy beliefs on COVID-19 vaccination uptake through the same factors. Overall, 69.57% (95% confidence interval, 67.55%-71.59%) of the participants were vaccinated and 83.48% of them received two or more doses. Those aged 55 years and older were less likely to be vaccinated, as well as those residing in British Columbia and Manitoba. Mediation models showed that the association between health literacy and COVID-19 vaccine uptake was mediated by confidence in health authorities (B = 0.02, p < 0.001), COVID-19-related stress (B = -0.02, p < 0.001), and racial discrimination (B = -0.01, p = 0.032), but both direct and total effects were nonsignificant. Lastly, conspiracy beliefs were found to have a partial mediation effect through the same mediators (B = 0.02, p < 0.001, B = -0.02, p < 0.001, B = -0.01, p = 0.011, respectively). These findings highlight the need for targeted interventions to address vaccine hesitancy and inform approaches to improve access to vaccinations among Black communities.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Caulley
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Marie-Hélène Chomienne
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Cénat JM, Darius WP, Dalexis RD, Kogan CS, Guerrier M, Ndengeyingoma A. Perceived racial discrimination, internalized racism, social support, and self-esteem among Black individuals in Canada: A moderated mediation model. Cultur Divers Ethnic Minor Psychol 2024; 30:118-129. [PMID: 35420837 DOI: 10.1037/cdp0000542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Black Canadians report experiencing various forms of racial discrimination disproportionately. This study aimed to: (a) examine the association between everyday racial discrimination and self-esteem; (b) test the mediating role of internalized racism and social support in the association between racial discrimination and self-esteem, and (c) test the moderating role of gender and age in this same relationship. METHOD A total of 860 participants (76.60% female) aged 15-40 (Mage = 24.96, SD = 6.31) completed questionnaires assessing racial discrimination, self-esteem, internalized racism, and social support. Descriptive and moderated mediation analyses were performed. RESULTS A total of 65.33% of participants were categorized as endorsing low self-esteem, with no significant difference between males and females (66.67% and 62.20%, respectively; χ² = 1.56, p = .47). Participants aged 25-40 exhibited a higher prevalence of low self-esteem compared to those aged 15-24 (89.91% and 58.54%, respectively, χ² = 37.31, p < .001). The results showed a progressive increase in the prevalence of low self-esteem commensurate with increasing levels of reported racial discrimination. Internalized racism (β = -.09, SE = .01, p < .001) and social support (β = .10, SE = .01, p < .001) mediated the association between everyday racial discrimination and self-esteem; whereas gender moderated the latter association (β = .17, SE = .04, p < .001; being a woman). CONCLUSIONS Results indicate a strong association between racial discrimination and low self-esteem. These findings provide a better understanding of the mechanisms underlying the development of self-esteem problems among Black individuals in Canada. They also have important relevance for the development of educational and clinical programs for prevention and intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Jude Mary Cénat
- Vulnerability, Trauma Resilience and Culture Research Laboratory (V-TRaCLab), Interdisciplinary Centre for Black Health, School of Psychology, University of Ottawa
| | - Wina Paul Darius
- Vulnerability, Trauma Resilience and Culture Research Laboratory (V-TRaCLab), Interdisciplinary Centre for Black Health, School of Psychology, University of Ottawa
| | | | - Cary S Kogan
- Interdisciplinary Centre for Black Health, School of Psychology, University of Ottawa
| | - Mireille Guerrier
- Vulnerability, Trauma Resilience and Culture Research Laboratory (V-TRaCLab), Interdisciplinary Centre for Black Health, School of Psychology, University of Ottawa
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Cénat JM, Moshirian Farahi SMM, Rousseau C, Bukaka J, Darius WP, Derivois D, Dalexis RD, Luyeye N. Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic. J Adolesc Health 2023; 73:1019-1029. [PMID: 37737753 DOI: 10.1016/j.jadohealth.2023.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018-2020 epidemic in Eastern Democratic Republic of the Congo. METHODS A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19. RESULTS The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ2(2) = 9.02; p = .011 and χ2(2) = 168.85; p < .001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%-72% of the variance of depression and PTSD. DISCUSSION The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Québec, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Noble Luyeye
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
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Cénat JM, Dromer E, Mistry S, Villarreal DG, Moshirian Farahi SMM, Dalexis RD, Darius WP, Bukaka J, Balayulu-Makila O, Luyeye N, Derivois D, Rousseau C. Prevalence and determinants of anxiety, depression and comorbid anxiety-depression symptoms among adolescents in Ebola-affected zones. BJPsych Open 2023; 9:e196. [PMID: 37850413 PMCID: PMC10594165 DOI: 10.1192/bjo.2023.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Ebola virus disease (EVD) has been shown to be associated with poor mental health in affected zones. However, no study has yet explored its impact on adolescents' mental health. AIMS This study aimed to assess the prevalence and risk factors associated with depression and anxiety symptoms among adolescents in EVD-affected areas in the Equateur Province of the Democratic Republic of the Congo during the COVID-19 pandemic. METHOD A provincial sample of adolescents aged 12-17 years (M = 14.84, s.d. = 1.49) living in the 18 urban and rural areas affected by the 2018 EVD outbreak completed a two-wave longitudinal survey. Surveys assessed symptoms of depression and anxiety, exposure to Ebola, social support and sociodemographic information. RESULTS A total of 490 participants completed the baseline and follow-up surveys, 50% of whom were female. Elevated and worsened depressive symptoms were observed among participants from the baseline (56.94%) to the follow-up (91.43%; z = -11.37, P < 0.001), whereas anxiety symptoms decreased from the baseline (36.33%) to follow-up (24.90%; z = 4.06, P < 0.001). The final generalised estimating equation model showed that anxiety symptoms decreased over time (B = -3.92, P < 0.001), while depression symptoms increased (B = 4.79, P < 0.001). Stigmatisation related to Ebola positively predicted anxiety (B = 5.41, P < 0.001) and depression symptoms (B = 0.4452, P = 0.009). Social support negatively predicted anxiety (B = -1.13, P = 0.004) and depression (B = -0.98, P < 0.001) symptoms but only moderated the association between stigmatisation and depression symptoms (B = -0.67, P < 0.001). CONCLUSIONS Most adolescents living in EVD-affected areas experience mental health issues. Stigmatisation related to EVD and living in urban areas are the most consistent predictors of mental health problems. Nevertheless, social support remains a protective factor for depression and anxiety symptoms and a necessary resource for building resilience.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada
| | - Elisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Shruti Mistry
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniela Gonzalez Villarreal
- Department of Clinical Psychology and Health, Monterrey Institute of Technology and Higher Education, Monterrey, Mexico
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Population Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, DR, Congo
| | | | - Noble Luyeye
- Department of Psychology, University of Kinshasa, Kinshasa, DR, Congo
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
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Cénat JM, Dromer É, Darius WP, Dalexis RD, Furyk SE, Poisson H, Mansoub Bekarkhanech F, Diao DG, Gedeon AP, Shah MS, Labelle PR, Bernheim E, Kogan CS. Incidence, Racial Disparities and Factors Related to Psychosis among Black Individuals in Canada: A Scoping Review. Can J Psychiatry 2023; 68:713-731. [PMID: 37269120 PMCID: PMC10517652 DOI: 10.1177/07067437231178957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Black communities are increasingly concerned about psychosis, a worry echoed by provincial health-care systems across Canada. Responding to the lack of evidence on psychosis in Black communities, this scoping review examined the incidence and prevalence of psychosis, access to care (pathways to care, coercive referrals, interventions, etc.), treatments received, and stigma faced by individuals with psychosis. METHOD To identify studies, a comprehensive search strategy was developed and executed in December 2021 across 10 databases, including APA PsycInfo, CINAHL, MEDLINE and Web of Science. Subject headings and keywords relating to Black communities, psychosis, health inequalities, Canada and its provinces and territories were used and combined. The scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping review (PRISMA-ScR) reporting standard. RESULTS A total of 15 studies met the inclusion criteria, all of them conducted in Ontario and Quebec. Results highlight different disparities in psychosis among Black communities. Compared to other Canadian ethnic groups, Black individuals are more likely to be diagnosed with psychosis. Black individuals with psychosis are more likely to have their first contact with health-care settings through emergency departments, to be referred by police and ambulance services, and to experience coercive referrals and interventions, and involuntary admission. Black individuals experience a lower quality of care and are the ethnic group most likely to disengage from treatment. CONCLUSION This scoping review reveals many gaps in research, prevention, promotion and intervention on psychosis in Black individuals in Canada. Future studies should explore factors related to age, gender, social and economic factors, interpersonal, institutional and systemic racism, and psychosis-related stigma. Efforts should be directed toward developing trainings for health-care professionals and promotion and prevention programs within Black communities. Culturally adapted interventions, racially disaggregated data, and increased research funding are needed.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Élisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Hannah Poisson
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | - Muhammad S. Shah
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Emmanuelle Bernheim
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Law, Civil Law Section, University of Ottawa, Ottawa, Ontario, Canada
- Canada Research Chair on Mental Health and Access to Justice, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary S. Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
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Cénat JM, Dromer É, Auguste E, Dalexis RD, Darius WP, Kogan CS, Guerrier M. Frequency and factors related to substance use among Black individuals aged 15-40 years old in Canada: The role of everyday racial discrimination. Psychol Addict Behav 2023; 37:695-708. [PMID: 36996238 DOI: 10.1037/adb0000913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE Despite evidence that Black individuals are confronted with various types of racial discrimination that put them at risk for alcohol and substance use disorders, no study in Canada has assessed the frequency and factors related to substance use in Black communities. This study thus aims to examine the frequency and factors related to substance use in Black communities in Canada. METHOD A total of 845 Black individuals in Canada (76.6% female) completed questionnaires assessing substance use (i.e., alcohol, cannabis, and other drugs), everyday racial discrimination, resilience, religious involvement, and sociodemographic information. Multivariable regression analyses were used to determine factors related to substance use among Black individuals. RESULTS The findings showed that 14.8% (95% CI [8.60, 20.94]) of participants reported using any substance (i.e., alcohol, cannabis, and other drugs) in the past 12 months. Men reported a significantly higher frequency of substance use than women (25.7% vs. 11.1%; x² = 27.67, p < .001). Everyday racial discrimination (ß = .27, p < .001) and place of birth (born in Canada, ß = .14, p < .001) were positively associated with substance use, whereas it was negatively associated with religiosity, resilience, and gender (being a female; ß = -.08, p < .05; ß = -.21, p < .001; ß = -.12, p < .001). CONCLUSIONS Racial discrimination is associated with substance use among Black individuals in Canada. The study findings inform potential prevention and intervention strategies by examining protective factors related to substance use (e.g., religiosity, resilience, gender) among Black individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Cénat JM, Farahi SMMM, Dalexis RD. Prevalence and determinants of depression, anxiety, and stress symptoms among Black individuals in Canada in the context of the COVID-19 pandemic. Psychiatry Res 2023; 326:115341. [PMID: 37482045 DOI: 10.1016/j.psychres.2023.115341] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
The COVID-19 pandemic has disproportionately affected Black communities in Canada in terms of infection, hospitalizations, and mortality rates. It exacerbated social, economic, and health disparities that can impact their mental health. We investigated the prevalence and predictors of symptoms of depression, anxiety, and stress in Black individuals in Canada. A community-representative weighted sample of 2002 Black individuals (51.66% women) aged 14 to 94 years old (Mean age 29.34; SD = 10.13). Overall, 40.94%, 44.50%, and 31.36% of participants were classified as having clinically meaningful anxiety, depression, and stress levels, respectively, based on DASS scores. Men (45.92%) reported a higher prevalence of anxiety than women (36.27%), χ2 (1) = 19.24, p<.001, but similar symptoms of depression and stress. The progression of the prevalence of anxiety, depression, and stress symptoms were consistent with the progression of the prevalence of everyday racial discrimination. After controlling for socio-demographic variables, regression models showed that everyday discrimination (B = 0.14, p=.001, B = 0.14, p= .006, B = 0.18, p< .001), major experiences of racial discrimination (B = 0.30, p=.046, B = 0.34, p= .033, B = 0.35, p=.024), and COVID-19 traumatic stressors (B = 0.43, p<.001, B = 0.43, p< .001, B = 0.44, p< .001) were positively associated with anxiety, while community resilience (B= -0.02, p= .039, B= -0.04, p= .001, B= -0.03, p= .014) was negatively associated with anxiety, depression, and stress, respectively. This study demonstrates the need to address racial discrimination in implementing prevention and intervention programs among Black individuals and to consider intersectional factors related to age, birthplace, language spoken, and province of residence.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Cénat JM, Moshirian Farahi SMM, Bakombo SM, Dalexis RD, Pongou R, Caulley L, Yaya S, Etowa J, Venkatesh V. Vaccine mistrust among Black individuals in Canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system. J Med Virol 2023; 95:e28738. [PMID: 37185858 DOI: 10.1002/jmv.28738] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
The COVID-19 pandemic disproportionately affected Black communities in Canada in terms of infection and mortality rates compared to the general population. Despite these facts, Black communities are among those with the highest level of COVID-19 vaccine mistrust (COVID-19 VM). We collected novel data to analyze the sociodemographic characteristics and factors associated with COVID-19 VM among Black communities in Canada. A survey was conducted among a representative sample of 2002 Black individuals (51.66% women) aged 14-94 years (M = 29.34; SD = 10.13) across Canada. Vaccine mistrust was assessed as the dependent variable and conspiracy theories, health literacy, major racial discrimination in healthcare settings, and sociodemographic characteristics of participants were assessed as independent variables. Those with a history of COVID-19 infection had higher COVID-19 VM score (M = 11.92, SD = 3.88) compared to those with no history of infection (M = 11.25, SD = 3.83), t (1999) = -3.85, p < 0.001. Participants who reported having experienced major racial discrimination in healthcare settings were more likely to report COVID-19 VM (M = 11.92, SD = 4.03) than those who were not (M = 11.36, SD = 3.77), t (1999) = -3.05, p = 0.002. Results also showed significant differences for age, education level, income, marital status, provinces, language, employment status, and religion. The final hierarchical linear regression showed that conspiracy beliefs (B = 0.69, p < 0.001) were positively associated with COVID-19 VM, while health literacy (B = -0.05, p = 0.002) was negatively associated with it. The mediated moderation model showed that conspiracy theories completely mediated the association between racial discrimination and vaccine mistrust (B = 1.71, p < 0.001). This association was also completely moderated by the interaction between racial discrimination and health literacy (B = 0.42, p = 0.008), indicating that despite having a high level of health literacy, those who experienced major racial discrimination in health services developed vaccine mistrust. This first study on COVID-19 VM exclusively among Black individuals in Canada provides data that can significantly impact the development of tools, trainings, strategies, and programs to make the health systems free of racism and increase their confidence in vaccination for COVID-19 and other infectious diseases.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada
| | | | - Schwab Mulopo Bakombo
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Roland Pongou
- Department of Economics, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Caulley
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Josephine Etowa
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- School of Nursing, University of Ottawa, Ontario, Canada
| | - Vivek Venkatesh
- Department of Art Education, Concordia University, Quebec, Montreal, Canada
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Cénat JM, Kogan CS, Kebedom P, Ukwu G, Moshirian Farahi SMM, Darius WP, Mulopo Bakombo S, Dalexis RD, Ndengeyingoma A, Noorishad PG, Labelle PR. Prevalence and risk factors associated with psychostimulant use among Black individuals: A meta-analysis and systematic review. Addict Behav 2023; 138:107567. [PMID: 36521424 DOI: 10.1016/j.addbeh.2022.107567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Psychostimulants (e.g., cocaine, amphetamine) are among the most widely used drugs globally with detrimental short and long-term physical, psychological and social consequences. There is limited data on psychostimulant use for various racial and ethnic groups, including Black people, and the challenges they face living as minorities overcoming historical challenges including increased incarceration associated with drug possession. METHODS Peer-reviewed articles were identified in five databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, MEDLINE). Eligible studies were published in French or English, provided empiral data on psychostimulant use in Black individuals living in a minority context. The PRISMA guideline was used for structuring the review. Random-effects meta-analyses were generated to estimate the pooled prevalence of lifetime and periodic psychostimulant use among Black individuals using STATA 16. RESULTS Sixty-three studies published from 1991 to 2022 with a sample size of 139,683 Black individuals were included in the current meta-analysis. Results indicate a pooled prevalence estimate of 11.4% for any form of psychostimulant use among Black individuals. The pooled prevalence estimates were 12.4% (95% CI, 8.4% - 16.4%) for cocaine, 8.3% (95% CI, 0% - 19.1%) for amphetamines, and 11.4% (95% CI, 4.6% - 18.1%) for other stimulants. Prediction intervals for all psychostimulant types were highly heterogenous ranging from 0% to as high as 51.2% for amphetamine suggesting prevalence of use in some studies of Black people could be found to be as low as zero. Subgroup analyses were conducted to examine differences between age groups, gender, reference period, and type of assessment. CONCLUSIONS High prevalence rates of psychostimulant use among Black people argues for greater access to evidence-based treatments. However, current psychosocial interventions are suboptimal, warranting further study. Consideration needs to be given to the challenges of the large range of prediction intervals, living in urban areas, racial discrimination experiences, race-based stress, and sociodemographic characteristics, including poverty, education level, age, gender.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Philmona Kebedom
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Gloria Ukwu
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Assumpta Ndengeyingoma
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
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11
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Cénat JM, Dalexis RD, Darius WP, Kogan CS, Guerrier M. Prevalence of Current PTSD Symptoms Among a Sample of Black Individuals Aged 15 to 40 in Canada: The Major Role of Everyday Racial Discrimination, Racial Microaggresions, and Internalized Racism. Can J Psychiatry 2023; 68:178-186. [PMID: 36172639 PMCID: PMC9974651 DOI: 10.1177/07067437221128462] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Most Black individuals in Canada report having experienced racial discrimination. Although previous studies have shown that there is a strong relationship between racial discrimination and posttraumatic stress disorder (PTSD), no studies in Canada have documented this association among Black individuals. The present study documents (1) the prevalence of PTSD among Black individuals using data from the Black Communities Mental Health project and (2) risk factors associated with PTSD, including racial microaggressions, everyday racial discrimination, and internalized racism. METHOD A total of 860 participants (75.6% of women) aged 15 to 40 years old (M = 24.96, SD = 6.29) completed questionnaires assessing PTSD, experience of traumatic events, racial microaggressions, everyday racial discrimination, and internalized racism. RESULTS Findings showed that 95.1% of participants reported exposure to at least one traumatic event during their lifetime. In total, 67.11% of participants reported probable PTSD with no significant difference between men and women (68.2% and 67.8%, χ2 = 0.132, p = 0.72). Participants born in Canada were more likely to experience significant PTSD symptoms, compared to those born abroad (70.92% and 53.14%, χ2 = 19.69, p < 0.001). A multivariable linear regression model of PTSD symptoms was computed using sociodemographic variables and exposure to traumatic events as independent variables, which explained 25.9% of the variance. In addition to these variables, a second model included racial microaggressions, everyday racial microaggressions, and internalized racism, which explained 51.8% of the variance. The model showed that traumatic events (b = 0.6; p = 0.02), racial microaggressions (b = 0.5; p < 0.001), everyday discrimination (b = 0.2; p = 0.03) and internalized racism (b = 0.5; p < 0.001) were positively associated with PTSD symptoms. CONCLUSIONS This article highlights the detrimental consequences of racial discrimination against Black people in Canada. Prevention and mental health programs aimed at mitigating its consequences on the lives of Black people and other racialized populations must be implemented.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada
- Jude Mary Cénat, School of Psychology, University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada.
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary S. Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
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12
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Cénat JM, Dalexis RD, Clorméus LA, Lafontaine MF, Guerrier M, Michel G, Hébert M. Lifetime and Child Sexual Violence, Risk Factors and Mental Health Correlates Among a Nationally Representative Sample of Adolescents and Young Adults in Haiti: A Public Health Emergency. J Interpers Violence 2023; 38:2778-2805. [PMID: 35576436 PMCID: PMC9850395 DOI: 10.1177/08862605221102484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Very little is known in Haiti and the Caribbean regarding child and lifetime sexual victimization. Using a nationally representative sample of adolescents and young adults aged 15-24, this study aimed to document the prevalence, risk factors and mental health correlates of lifetime and child sexual violence in Haiti. A national cross-sectional surrvey was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24 years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall rate of lifetime and child sexual violence was, respectively, 27.44% (95% CI 25.94-28.94) and 11.27% (95% CI 10.18-12.35). Lifetime sexual violence rate was significantly higher among female participants (29.02%; 95% CI 27.5-30.55) compared to male (25.73%, 95% CI 24.26-27.2), χ2 = 4.63, p < .05, but there was no significant gender difference for child sexual victimization. Experiences of family physical violence, emotional abuse by mother and father, divorce of parents, and other physical violence were strongly associated with higher odds of sexual victimization. Participants who reported having experienced sexual violence are more at risk to meet criteria of PTSD (OR = 1.96, 95% CI 1.66-2.32; p < .0001), depression (OR = 1.73, 95% CI 1.47-2.02; p < .0001), psychological distress (OR =1.72, 95% CI 1.47-2.02; p < .0001), and substance abuse (OR = 1.33, 95% CI 1.13-1.57; p < .0001). Findings demonstrate that sexual violence is a public health emergency in Haiti. They provide evidence for the development of prevention and intervention programs.
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Affiliation(s)
| | - Rose Darly Dalexis
- Interdisciplinary School of Health
Sciences, University
of Ottawa, Ontario, Canada
| | | | | | | | | | - Martine Hébert
- Department of Sexology,
Université du
Québec à Montréal, Québec, Canada
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13
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Cénat JM, Dromer É, Darius WP, Dalexis RD, Furyk SE, Poisson H, Mansoub Bekarkhanechi F, Shah M, Diao DG, Gedeon AP, Lebel S, Labelle PR. Incidence, factors, and disparities related to cancer among Black individuals in Canada: A scoping review. Cancer 2023; 129:335-355. [PMID: 36436148 DOI: 10.1002/cncr.34551] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Canada, two of five individuals will be diagnosed with cancer in their lifetime and one in four will die from this disease. Given the disparities observed in health research among Black individuals, we conducted a scoping review to analyze the state of cancer research in Canadian Black communities regarding prevalence, incidence, screening, mortality, and related factors to observe advances and identify gaps and disparities. METHODS A comprehensive search strategy was developed and executed in December 2021 across 10 databases (e.g., Embase). Of 3451 studies generated by the search, 19 were retained for extraction and included in this study. RESULTS Studies were focused on a variety of cancer types among Black individuals including anal, breast, cervical, colorectal, gastric, lung, and prostate cancers. They included data on incidence, stage of cancer at diagnosis, type of care received, diagnostic interval length, and screening. A few studies also demonstrated racial disparities among Black individuals. This research reveals disparities in screening, incidence, and quality of care among Black individuals in Canada. CONCLUSIONS Given the gaps observed in cancer studies among Black individuals, federal and provincial governments and universities should consider creating special funds to generate research on this important health issue. PLAIN LANGUAGE SUMMARY Important gaps were observed on research on cancer among Black communities in Canada. Studies included in the scoping review highlights disparities in screening, incidence, and quality of care among Black individuals in Canada.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.,Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada.,University of Ottawa Research Chair on Black Health, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Élisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Hannah Poisson
- Faculty of Science, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Muhammad Shah
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - David Guangyu Diao
- Faculty of Arts and Science, McGill University, Montreal, Quebec, Canada
| | | | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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14
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Cénat JM, Broussard C, Darius WP, Onesi O, Auguste E, El Aouame AM, Ukwu G, Khodabocus SN, Labelle PR, Dalexis RD. Social mobilization, education, and prevention of the Ebola virus disease: A scoping review. Prev Med 2023; 166:107328. [PMID: 36356934 DOI: 10.1016/j.ypmed.2022.107328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 09/05/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
The Ebola Virus Disease (EVD) remains a global public health concern with multiple outbreaks over the last five years. This scoping review aimed to synthesize the current state of knowledge on awareness, education, and community mobilization programs on EVD prevention. A comprehensive search strategy was executed in October 2021 across eight databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, Global Health, MEDLINE, Scopus, and Web of Science). According to the PRISMA flow diagram, out of the 4815 studies generated by the search, 33 were retained for extraction and were included in this scoping review. Findings revealed that cultural practices that increased the risk of Ebola transmission remain very prevalent, even educational and awareness campaigns. Levels of Ebola-related knowledge by community members varied widely. A large proportion of the Ebola-affected populations were not aware of modes of transmission and half were unaware of signs and symptoms. Interventions with deep community mobilization, collaboration and engagement were effective in changing cultural practices, and reducing rates of infection. Interventions in the health sector helped increase willingness to practice preventive methods and the maintenance of social distancing and patient handwashing. A majority of the population members received their information about EVD from the community and mass media (in most instances, through broadcasting stations). Community interventions with a collaborative approach are effective to prevent EVD. It is needed to build trust between communities and health care, but also to use local resources and cultural factors combined with the use of technologies of information to prevent EVD.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | - Olivia Onesi
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | | | - Gloria Ukwu
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
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15
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Cénat JM, Kouamou LN, Moshirian Farahi SMM, Darius WP, Dalexis RD, Charles M, Kogan CS. Perceived racial discrimination, psychosomatic symptoms, and resilience among Black individuals in Canada: A moderated mediation model. J Psychosom Res 2022; 163:111053. [PMID: 36244137 DOI: 10.1016/j.jpsychores.2022.111053] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Although no study has explored psychosomatic symptoms in Black communities in Canada, several studies in the United States showed that psychological distress is often express as physical pain among African Americans. Using a cross-sectional design, the present study documents the frequency of psychosomatic symptoms and its association to racial discrimination, and resilience among Black individuals aged 15 to 40 in Canada. METHOD A total of 860 participants (Mage = 25.0 years, SD = 6.3), predominantly born in Canada (79.1%) and women (75.6%), completed the Symptom Checklist-90-Revised (somatization subscale), the Everyday Discrimination Scale, and the Resilience Scale-14. RESULTS Findings revealed that 81.7% of participants experienced psychosomatic symptoms, with higher prevalence among women (84.2%) compared to men (70.7%;), ꭓ2 = 21.5, p < .001; participants aged 25 to 40 years old (93.7%) compared to those aged 15-24 years old (75.2%) (ꭓ2 = 45.0, p < .001). Participants reporting greater racial discrimination had more psychosomatic symptoms (89.4%) compared to others (72.9%), ꭓ2 = 39.2, p < .001). A moderated mediation model showed that everyday racial discrimination was positively associated with psychosomatic symptoms (B = 0.1, SE = 0.01, p < .001). The model showed that the association between racial discrimination and psychosomatic symptoms was partially mediated by resilience (B = -0.01, SE = 0.0, p < .01), and negatively moderated by gender (B = -0.04, SE = 0.01, p < .01). In other words, being a woman is associated with higher levels of psychosomatic symptoms among those who have experienced racial discrimination. CONCLUSION By highlighting the association between racial discrimination and psychosomatic symptoms and the role of resilience and gender in this relation, this article reveals important factors to integrate to improve healthcare services, prevention, and interventions among Black individuals with psychosomatic symptoms.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Michée Charles
- Department of Sociology, Université Toulouse Jean Jaurès, Toulouse, France
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ontario, Canada
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16
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Cénat JM, Noorishad PG, Bakombo SM, Onesi O, Mesbahi A, Darius WP, Caulley L, Yaya S, Chomienne MH, Etowa J, Venkatesh V, Dalexis RD, Pongou R, Labelle PR. A Systematic Review on Vaccine Hesitancy in Black Communities in Canada: Critical Issues and Research Failures. Vaccines (Basel) 2022; 10:1937. [PMID: 36423032 PMCID: PMC9695687 DOI: 10.3390/vaccines10111937] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 07/25/2023] Open
Abstract
Black communities have been disproportionately impacted by Coronavirus Disease 2019 (COVID-19) in Canada, in terms of both number of infections and mortality rates. Yet, according to early studies, vaccine hesitancy appears to be higher in Black communities. The purpose of this systematic review is to examine the prevalence and factors associated with vaccine hesitancy in Black communities in Canada. Peer-reviewed studies published from 11 March 2020 to 26 July 2022, were searched through eleven databases: APA PsycInfo (Ovid), Cairn.info, Canadian Business & Current Affairs (ProQuest), CPI.Q (Gale OneFile), Cochrane CENTRAL (Ovid), Embase (Ovid), Érudit, Global Health (EBSCOhost), MEDLINE (Ovid), and Web of Science (Clarivate). Eligible studies were published in French or English and had empirical data on the prevalence or factors associated with vaccine hesitancy in samples or subsamples of Black people. Only five studies contained empirical data on vaccine hesitancy in Black individuals and were eligible for inclusion in this systematic review. Black individuals represented 1.18% (n = 247) of all included study samples (n = 20,919). Two of the five studies found that Black individuals were more hesitant to be vaccinated against COVID-19 compared to White individuals, whereas the other three found no significant differences. The studies failed to provide any evidence of factors associated with vaccine hesitancy in Black communities. Despite national concerns about vaccine hesitancy in Black communities, a color-blind approach is still predominant in Canadian health research. Of about 40 studies containing empirical data on vaccine hesitancy in Canada, only five contained data on Black communities. None analyzed factors associated with vaccine hesitancy in Black communities. Policies and strategies to strengthen health research in Black communities and eliminate the color-blind approach are discussed.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Faculty of Social Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | | | - Schwab Mulopo Bakombo
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Olivia Onesi
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Aya Mesbahi
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Lisa Caulley
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Faculty of Medicine, Family Medicine University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Ottawa, ON K1N 6N5, Canada
- The George Institute for Global Health, Imperial College London, London NW9 7PA, UK
| | - Marie-Hélène Chomienne
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Faculty of Medicine, Family Medicine University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Institut du Savoir Montfort, Ottawa, ON K1K 0T2, Canada
| | - Josephine Etowa
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Nursing, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Vivek Venkatesh
- Department of Art Education, Concordia University, Montreal, QC H3H 1M8, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Roland Pongou
- Department of Economics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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17
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Cénat JM, Hajizadeh S, Dalexis RD, Ndengeyingoma A, Guerrier M, Kogan C. Prevalence and Effects of Daily and Major Experiences of Racial Discrimination and Microaggressions among Black Individuals in Canada. J Interpers Violence 2022; 37:NP16750-NP16778. [PMID: 34120505 DOI: 10.1177/08862605211023493] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The prevalence and correlates of different forms of racial discrimination among Black Canadians are unknown. This article aims to examine the prevalence of different forms of racial discrimination (daily, major and microaggressions) and their association with self-esteem and satisfaction with life among Black Canadians. A convenience sample of 845 Black Canadians aged 15-40 was recruited. We assessed frequencies of everyday and major racial discrimination, and racial microaggressions against Black Canadians and their association with self-esteem and satisfaction with life, controlling for gender, age, job status, education, and matrimonial status. At least 4 out of 10 participants declared having being victims of everyday racial discrimination at least once per week. Between 46.3% and 64.2% of participants declared having been victims of major racial discrimination in various situations including education, job hiring, job dismissal, health services, housing, bank and loans, and police encounters. Significant gender differences were observed for everyday and major racial discrimination with higher frequencies among female participants. A total of 50.2% to 93.8% of participants declared having been victims of at least one episode of racial microaggressions. Results showed a significant negative association between racial discrimination and satisfaction with life (b = -0.26, p = .003), and self-esteem (b = -0.23, p = .009). This study highlights the need to stop colorblind policies in different sectors in Canada, and for a public commitment to combat racism at the municipal, provincial and federal levels. Implications are discussed for prevention, research and public health.
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Affiliation(s)
| | - Saba Hajizadeh
- School of Psychology, University of Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | | | | | - Cary Kogan
- School of Psychology, University of Ottawa, Ontario, Canada
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18
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Cénat JM, Farahi SMMM, Dalexis RD, Darius WP, Bukaka J, Balayulu-Makila O, Luyeye N, Derivois D, Rousseau C. Mental distress before and during the COVID-19 pandemic: A longitudinal study among communities affected by Ebola virus disease in the DR Congo. Psychiatry Res 2022; 314:114654. [PMID: 35660968 PMCID: PMC9137240 DOI: 10.1016/j.psychres.2022.114654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 10/27/2022]
Abstract
BACKGROUND Associated with high mortality rate, fear, and anxiety, Ebola Virus Disease (EVD) is a significant risk factor for mental distress. This longitudinal study aims to investigate the prevalence and predictors associated with mental distress among populations affected by EVD outbreaks in the Province of Equateur in DR Congo. METHODS Surveys were administered in zones affected by the 2018 EVD outbreak in Equateur Province with a 16-month interval. Measures assessed sociodemographic characteristics, mental distress (GHQ-12), COVID-19 and EVD exposure and related stigmatization, and Resilience. Models of logistic regression and path analysis were used to estimate factors related to mental distress outcomes. RESULTS Prevalence of mental distress decreased from Wave 1 to Wave 2 (Mental distressT1= 57.04%, Mental distressT2= 40.29%, x2= 23.981, p<.001). Clinical mental distress score at follow-up was predicted by greater levels of exposure to Ebola at baseline (B= .412, p<.001) and at Wave 2 (B= .453, p<.001) as well as Ebola stigmatization at baseline (B= .752, p<.001), and Protestant religion (B= .474, p=.038). Clinical mental distress score at follow-up was significantly associated with higher levels of exposure to COVID-19 (B= .389, p=.002) and COVID-19 related stigmatization (B= .480, p<.001). COVID-19 related stigmatization partially mediated the association between exposure to EVD (Time 1) and mental distress (B= .409, p<.001). CONCLUSIONS Although a decrease in mental distress symptoms was observed, its prevalence remains high. The results show that mental health programs need to develop better health and education communication strategies to reduce stigmatization.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada.
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | | | - Jacqueline Bukaka
- Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Oléa Balayulu-Makila
- Department of psychology, University of Kinshasa, Kinshasa, DR of Congo,Department of psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Noble Luyeye
- Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Daniel Derivois
- Department of psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
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19
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Cénat JM, Mukunzi JN, Amédée LM, Clorméus LA, Dalexis RD, Lafontaine MF, Guerrier M, Michel G, Hébert M. Prevalence and factors related to dating violence victimization and perpetration among a representative sample of adolescents and young adults in Haiti. Child Abuse Negl 2022; 128:105597. [PMID: 35339796 DOI: 10.1016/j.chiabu.2022.105597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/14/2022] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Studies examining both victimization and perpetration of dating violence among both women and men are virtually non-existent in Haiti. This study aimed to document the prevalence and factors associated with victimization and perpetration of dating violence (DV) among adolescents and young adults aged 15-24 years in Haiti. PARTICIPANTS AND SETTING A total of 3586 participants (47.6% women; mean age = 19.37; SD = 2.71) were sampled in the 10 geographical departments according to residence areas (urban/rural), age group (15-19/20-24 years old), and gender (men/women). METHOD Participants completed questionnaires assessing DV victimization and perpetration, witnessing interparental violence, parental violence, violence acceptance, social desirability, and self-esteem. RESULTS Overall, 1538 participants (56% women) were in a romantic relationship in the past year. Results showed that men were more likely to experience both psychological (49.4% of women and 57% of men, X2 = 8.17, p = .004), and physical violence (11.1% of women and 18.8% of men, X2 = 8.13, p = .004). There were marginally significant differences for sexual violence between gender for adolescents aged 15 to 19 (26.5% of girls and 20.5% of boys, X2 = 3.25, p = .07), and not for young adults (21.8% of women and 24.0% of men, X2 = 0.49, p = .48). No significant difference was observed for any forms of DV perpetration. DV perpetration was positively associated with victimization (b = 0.5, p = .002), however victimization was not associated with perpetration. Results also showed different associations between violence perpetration and victimization, gender, social desirability, acceptance of violence, parental violence, and witnessing interparental violence. CONCLUSIONS This study highlights avenues for prevention and intervention that must begin at an early age, engage teachers, train peer-educators, promote healthy, non-violent and egalitarian romantic relationships.
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Affiliation(s)
- Jude Mary Cénat
- Vulnerability, Trauma, Resilience & Culture Research Laborattory (V-TRaC Lab), School of Psychology, University of Ottawa, Ontario, Canada.
| | - Joana N Mukunzi
- Vulnerability, Trauma, Resilience & Culture Research Laborattory (V-TRaC Lab), School of Psychology, University of Ottawa, Ontario, Canada
| | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | | | - Mireille Guerrier
- Vulnerability, Trauma, Resilience & Culture Research Laborattory (V-TRaC Lab), School of Psychology, University of Ottawa, Ontario, Canada
| | | | - Martine Hébert
- Canada Research Chair in Interpersonal Trauma and Resilience, Department of Sexology, Université du Québec à Montréal, Québec, Canada
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Cénat JM, Kokou-Kpolou CK, Blais-Rochette C, Morse C, Vandette MP, Dalexis RD, Darius WP, Noorishad PG, Labelle PR, Kogan CS. Prevalence of ADHD among Black Youth Compared to White, Latino and Asian Youth: A Meta-Analysis. J Clin Child Adolesc Psychol 2022:1-16. [PMID: 35427201 DOI: 10.1080/15374416.2022.2051524] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To systematically review the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Black children and adolescents compared to White, Latino and Asian children and adolescents. METHOD Peer-reviewed articles were identified in seven databases and included if they reported prevalence of ADHD among Black children and adolescents living in a minority context and compared rates to at least one of White, Latino or Asian samples. A total of 7050 articles were retrieved and 155 articles were subjected to full evaluation. Twenty-three studies representing 26 independent samples were included. RESULTS The pooled sample size was n = 218,445 (k = 26), n = 835,505 (k = 25), n = 493,417 (k = 24), and n = 66,413 (k = 7) of Black, White, Latino, and Asian participants, respectively. Pooled prevalence rate of ADHD was 15.9% (95%CI 11.6% - 20.7%) among Black children and adolescents, 16.6% (95%CI 11.6% - 22.2%) among Whites, 10.1% (95%CI 6.9% - 13.8%) among Latinos and 12.4% (95%CI 1.4% - 31.8%) among Asians. There was no significant difference in prevalence between ethnic groups, whereas both Black and White children and adolescents had marginally statistically significant higher prevalence than Asians. The results of a meta-regression analysis showed no moderating effects of the type of sample and the year of publication of studies. A significant publication bias was observed, suggesting that other moderators were not identified in the present systematic review. CONCLUSION In contrast to the assertion in the DSM-5 that clinical identification among Black children and adolescents is lower than among White children and adolescents, the present meta-analysis suggests similar rates of ADHD among these two groups. The importance of considering cultural appropriateness of assessment tools and processes is emphasized.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa
- Interdisciplinary Centre for Black Health, University of Ottawa
| | | | | | | | | | | | | | | | | | - Cary S Kogan
- School of Psychology, University of Ottawa
- Interdisciplinary Centre for Black Health, University of Ottawa
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21
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Cénat JM, Noorishad PG, Dalexis RD, Rousseau C, Derivois D, Kokou-Kpolou CK, Bukaka J, Balayulu-Makila O, Guerrier M. Prevalence and risk factors of depression symptoms among rural and urban populations affected by Ebola virus disease in the Democratic Republic of the Congo: a representative cross-sectional study. BMJ Open 2022; 12:e053375. [PMID: 35017247 PMCID: PMC8753092 DOI: 10.1136/bmjopen-2021-053375] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/20/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES High mortality rates, anxiety and distress associated with Ebola virus disease (EVD) are risk factors for mood disorders in affected communities. This study aims to document the prevalence and risk factors associated with depressive symptoms among a representative sample of individuals affected by EVD. DESIGN Cross-sectional study. SETTING The current study was conducted 7 months (March 11, 2019 to April 23, 2019) after the end of the ninth outbreak of EVD in the province of Equateur in the Democratic Republic of the Congo (DRC). PARTICIPANTS A large population-based sample of 1614 adults (50% women, Mage=34.05; SD=12.55) in health zones affected by the ninth outbreak in DRC. PRIMARY AND SECONDARY OUTCOME MEASURES Participants completed questionnaires assessing EVD exposure level, stigmatisation related to EVD and depressive symptoms. The ORs associated with sociodemographic data, EVD exposure level and stigmatisation were analysed through logistic regressions. RESULTS Overall, 62.03% (95% CI 59.66% to 64.40%) of individuals living in areas affected by EVD were categorised as having severe depressive symptoms. The multivariable logistic regression analyses showed that adults in the two higher score categories of exposure to EVD were at two times higher risk of developing severe depressive symptoms (respectively, OR 1.94 (95% CI 1.22 to 3.09); OR 2.34 (95% CI 1.26 to 4.34)). Individuals in the two higher categories of stigmatisation were two to four times more at risk (respectively, OR 2.42 (95% CI 1.53 to 3.83); OR 4.73 (95% CI 2.34 to 9.56)). Living in rural areas (OR 0.19 (95% CI 0.09 to 0.38)) and being unemployed (OR 0.68 (95% CI 0.50 to 0.93)) increased the likelihood of having severe depressive symptoms. CONCLUSIONS Results indicate that depressive symptoms in EVD affected populations is a major public health problem that must be addressed through culturally adapted mental health programs.
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Affiliation(s)
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche-Comté, Dijon, Franche-Comté, France
| | | | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
| | - Oléa Balayulu-Makila
- Department of Psychology, Université Bourgogne Franche-Comté, Dijon, Franche-Comté, France
- Department of Psychology, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the)
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Cénat JM, Rousseau C, Bukaka J, Dalexis RD, Guerrier M. Severe Anxiety and PTSD Symptoms Among Ebola Virus Disease Survivors and Healthcare Workers in the Context of the COVID-19 Pandemic in Eastern DR Congo. Front Psychiatry 2022; 13:767656. [PMID: 35599776 PMCID: PMC9120641 DOI: 10.3389/fpsyt.2022.767656] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Ebola virus disease (EVD) survivors and healthcare workers (HCWs) face stress, fear, and stigma during the COVID-19 pandemic that can induce severe symptoms of anxiety and post-traumatic stress disorder (PTSD). We examined the prevalence and factors related to severe PTSD and anxiety symptoms, using a representative sample of survivors of the 2018-2020 EVD epidemic in DR Congo in comparison HCWs. Five hundred sixty-three participants (55.25% women, 309 survivors, 202 HCWs, and 52 HCWs and survivors) completed questionnaires assessing anxiety, PTSD, exposure to EVD and COVID-19, stigmatization related to EVD and COVID-19, interpersonal traumas, social support. During the COVID-19 pandemic, 45.6 and 75.0% of survivors and HCWs reported severe symptoms of PTSD and anxiety. Significant difference was observed among the three groups for both PTSD (53.7% survivors, 37.1% HCWs, and 30.8% HCWs-survivors, χ2= 18.67, p < 0.0001) and anxiety (88.3% survivors, 56.9% HCWs, and 65.4% HCWs- survivors, χ2= 67.03, p < 0.0001). Comorbidity of severe PTSD and anxiety symptoms was 42.3% between the three groups. Results revealed that exposure to EVD (b = 0.53; p = 0.001; b = 0.12; p = 0.042), EVD-related stigmatization (b = 0.14; p = 0.018; b = 0.07; p = 0.006), COVID-19-related stigmatization (b = 0.22; p < 0.0001; b = 0.08; p = 0.0001) and social support (b = -0.30; p < 0.0001; b = -0.14; p < 0.0001) predicted severe PTSD and anxiety symptoms. The last models explained 63.8 and 56.4% of the variance of PTSD and anxiety. Symptoms of PTSD and anxiety are common among EVD survivors and HCWs during the COVID-19 pandemic. Culturally-sensitive programs that address stigma are necessary to mitigate the cumulative effects of EVD and the COVID-19 pandemic on EVD survivors and HCWs.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, QC, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Cénat JM, Dalexis RD, Derivois D, Hébert M, Hajizadeh S, Kokou-Kpolou CK, Guerrier M, Rousseau C. Corrigendum: The Transcultural Community Resilience Scale: Psychometric Properties and Multinational Validity in the Context of the COVID-19 Pandemic. Front Psychol 2021; 12:771706. [PMID: 34690903 PMCID: PMC8532993 DOI: 10.3389/fpsyg.2021.771706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2021.713477.].
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
| | - Saba Hajizadeh
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, QC, Canada
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Cénat JM, Kokou-Kpolou CK, Mukunzi JN, Dalexis RD, Noorishad PG, Rousseau C, Derivois D, Bukaka J, Balayulu-Makila O, Guerrier M. Ebola virus disease, stigmatization, peritraumatic distress, and posttraumatic stress disorder in the Democratic Republic of the Congo: A moderated mediation model. J Affect Disord 2021; 293:214-221. [PMID: 34217958 DOI: 10.1016/j.jad.2021.06.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mechanisms worsening the development of Posttraumatic stress disorder (PTSD) symptoms among individuals affected by high-mortality epidemics are unclear. This study examined the prevalence of PTSD and related risk factors among populations affected by the Ebola virus disease (EVD) outbreak, and investigated whether peritraumatic distress mediates the impact of exposure level to EVD on PTSD symptoms, and the moderation role of stigmatization. METHODS The sample included 1614 participants (50% women) affected by EVD in Democratic Republic of the Congo (DRC). Participants completed the PTSD Check-List for DSM-5, Peritraumatic Distress Inventory, and measures evaluating levels of exposure and stigmatization related to EVD. Descriptive analyses and a moderated mediation model were computed. RESULTS A total of 58.81% participants (95% CI: 56.41%; 61.21%) met PTSD diagnostic criteria. Participants living in rural areas presented greater risk, while there is no significant difference between men and women. Peritraumatic distress mediated partially the association between exposure to EVD and PTSD symptoms. Moreover, this relationship was moderated by stigmatization related to EVD. LIMITATIONS As the design was cross-sectional, this study could not examine the causality of PTSD symptoms among communities affected by EVD. CONCLUSIONS This study shows high prevalence rates and important risk factors associated with PTSD in populations affected by EVD. It indicates elements that could help to develop and implement prevention and intervention programs in affected communities.
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Affiliation(s)
| | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada
| | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
| | - Daniel Derivois
- Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France
| | - Jacqueline Bukaka
- Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Oléa Balayulu-Makila
- Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France; Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
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Cénat JM, Dalexis RD, Derivois D, Hébert M, Hajizadeh S, Kokou-Kpolou CK, Guerrier M, Rousseau C. The Transcultural Community Resilience Scale: Psychometric Properties and Multinational Validity in the Context of the COVID-19 Pandemic. Front Psychol 2021; 12:713477. [PMID: 34489816 PMCID: PMC8417301 DOI: 10.3389/fpsyg.2021.713477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Few instruments assess community resilience. In the midst of the COVID-19 pandemic, the capacity of communities to support resilience of members deserves to be assessed to develop programs for improving mental health of affected populations. This article presents the development of the Ottawa-Community Resilience Scale (O-CRS), its underlying factorial structure and transcultural validity with a multilingual (English, French, Creole, Kinyarwanda), multinational (DR Congo, Haiti, Rwanda, Togo) and multicultural sample affected by this pandemic. A sample of 1,267 participants (40.9% women) were recruited in the four countries: DRC (n = 626, 43.4% women), Haiti (n = 225, 42.0% women), Rwanda (n = 174, 40.5% women), and Togo (n = 242, 33.2% women), with a mean age of 32 (SD = 10.1). They completed measures assessing individual resilience, depression and the O-CRS. Exploratory and confirmatory Factor Analyses, Cronbach alpha, coefficient H and the McDonald's Omega, and bivariate regression were used to estimate the underlying components of the O-CRS, its internal consistency and concurrent validity. Parallel factorial analysis and confirmatory factor analysis results revealed an excellent fit 3-factor structure. Internal consistency coefficients varied between 0.82 and 0.95. The O-CRS showed a good construct validity with a positive association with individual resilience and negative association with depression score. Developed with a collaborative approach involving researchers, practitioners, and clients/patients, the O-CRS and its three factors (community strengths and support, community trust and faith, and community values) demonstrated excellent psychometric properties for assessing community resilience among adults during the COVID-19 pandemic.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal (UQAM), Montréal, QC, Canada
| | - Saba Hajizadeh
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | | | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montréal, QC, Canada
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Cénat JM, Kogan C, Noorishad PG, Hajizadeh S, Dalexis RD, Ndengeyingoma A, Guerrier M. Prevalence and correlates of depression among Black individuals in Canada: The major role of everyday racial discrimination. Depress Anxiety 2021; 38:886-895. [PMID: 33949750 DOI: 10.1002/da.23158] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/16/2021] [Accepted: 04/02/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Depression is a common mental health problem causing significant disability globally, including in Canada. Prevalence estimates for depression within Black communities in Canada are unknown. This study determined the prevalence of depression in a sample of Black Canadians and the association between everyday racial discrimination experiences and depression. METHODS We analyzed data collected from the Black Community Mental Health project in Canada. Participants provided sociodemographic information and completed measures assessing depressive symptomology, everyday racial discrimination, and social support. The prevalence of depressive symptomatology was computed across sociodemographic variables and categories of everyday racial discrimination. Different regression models were conducted to examine the relationship between depressive symptoms and everyday racism controlling for sociodemographic factors. RESULTS In total, 65.87% of participants reported severe depressive symptoms, with higher rates among women, those who are employed, and those born in Canada. The linear regression models showed that everyday racial discrimination is the best predictor of depressive symptoms, with a final model explaining 25% of the variance. A logistic regression model demonstrated that those experiencing a high level of racial discrimination are 36.4 more likely to present severe depressive symptoms when compared to those reporting a low level of discrimination. CONCLUSIONS Rates of depressive symptoms among Black individuals are nearly six times the 12-month prevalence reported for the general population in Canada. Racial discrimination, which significantly predicts greater depressive symptomatology, is consistent with earlier studies in the United States and suggests that Canadian colorblind policies may inadvertently reinforce racial discrimination with detrimental effects on mental health.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Cary Kogan
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Pari-Gole Noorishad
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Saba Hajizadeh
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Mireille Guerrier
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Cénat JM, Harerimana B, Michel G, McIntee SE, Mukunzi JN, Hajizadeh S, Dalexis RD. The global challenge of providing mental health services in poverty: the situation of Northern Haiti. BJPsych Int 2021. [DOI: 10.1192/bji.2021.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
When people living in poverty are asked to describe their living conditions, mental health issues quickly come to mind (grief, sadness, anger, fear, bitterness, frustration, discontent, anxiety, and emotional damage consisting of low mood and depression, fatigue, hypersensitivity, sleep difficulties and physical pain). Although the association between poverty and mental health have been widely demonstrated in the literature, care must be taken to avoid the psychiatrization of poverty. However, how can healthcare be provided to people living in poverty when basic needs are not met? This article explores the global challenge of providing mental health services in impoverished populations, using the example of the poorest country in America: Haiti. It examines the availability of services offered through the Mental Health Centre at Morne Pelé, and the necessity for innovative and comprehensive approaches to provide culturally appropriate care that meets the real needs of populations. It highlights effective measures that policy makers should implement to develop an efficient mental healthcare system based on the lessons of the Mental Health Centre at Morne Pelé.
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Cénat JM, Blais-Rochette C, Kokou-Kpolou CK, Noorishad PG, Mukunzi JN, McIntee SE, Dalexis RD, Goulet MA, Labelle PR. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res 2021; 295:113599. [PMID: 33285346 PMCID: PMC7689353 DOI: 10.1016/j.psychres.2020.113599] [Citation(s) in RCA: 485] [Impact Index Per Article: 161.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to estimate the pooled prevalence of depression, anxiety, insomnia, PTSD, and Psychological distress (PD) related to COVID-19 among affected populations. METHODS We searched articles in Medline, Embase, APA PsycInfo, CINAHL, Scopus, and Web of Science. Random-effects meta-analyses on the proportions of individuals with symptoms of depression, anxiety, insomnia, PTSD, and PD were generated and between-group differences for gender, healthcare workers (HCWs), and regions where studies were conducted. RESULTS A total of 2189 articles were screened, 136 full-text articles were assessed for eligibility. Fifty-five peer-reviewed studies met inclusion criteria for the meta-analysis (N=189,159). The prevalence of depression (k=46) was 15.97% (95%CI, 13.24-19.13). The prevalence of anxiety (k=54) was 15.15% (95%CI, 12.29-18.54). The prevalence of insomnia (k=14) was 23.87% (95%CI, 15.74-34.48). The prevalence of PTSD (k=13) was 21.94% (95%CI, 9.37-43.31). Finally, the prevalence of psychological distress (k=19) was 13.29% (95%CI, 8.80-19.57). Between-group differences were only found in HCWs (z=2.69, p < 0.05) who had a higher prevalence of insomnia than others. CONCLUSIONS Findings suggest that the short-term mental health consequences of COVID-19 are equally high across affected countries, and across gender. However, reports of insomnia are significantly higher among HCWs than the general population.
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Affiliation(s)
- Jude Mary Cénat
- School of psychology, University of Ottawa, Ontario, Canada.
| | | | | | | | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
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Cénat JM, McIntee SE, Guerrier M, Derivois D, Rousseau C, Dalexis RD, Bukaka J, Makila-Balayulu O. Psychological distress among adults from the urban and rural areas affected by the Ebola virus disease in the Democratic Republic of the Congo. Soc Psychiatry Psychiatr Epidemiol 2021; 56:57-62. [PMID: 32537693 DOI: 10.1007/s00127-020-01904-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/11/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Ebola virus disease (EVD) is associated with high anxiety and multiple bereavement that can induce severe psychological distress (SPD) in individuals living in affected communities. Using data from the EVD and Mental Health project (EboMH), this study assessed the prevalence and determinants of SPD symptoms in a representative sample of adults in communities affected by EVD. METHODS A representative sample of 1614 adults (50% women) aged 18-85 years completed measures assessing exposure level to EVD, stigmatization related to EVD, and psychological distress. RESULTS In total, 45.58% of individuals from the cities and villages affected by EVD reported SPD. Results showed significant differences for residence area, employment, age, education level, and religion, but not for gender. Exposure level to EVD (β = 0.11, p < 0.001; OR = 1.12, 95% CI [1.08-1.16]), stigmatization related to EVD (β = 0.06, p < 0.001; OR = 1.06, 95% CI [1.05-1.07]), and living in rural areas (β = 0.67, p < 0.001; OR = .51, 95% CI [.36-.72]) predicted SPD symptoms. CONCLUSIONS Evidence-based global mental health programs in high-risk mortality epidemic contexts should take into account the high psychological distress in the affected areas.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, ON, K1N 6N5, Canada.
| | - Sara- Emilie McIntee
- School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Mireille Guerrier
- School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4017, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Daniel Derivois
- Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
| | - Rose Darly Dalexis
- School of Industrial Relations, University of Montreal, Montreal, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Oléa Makila-Balayulu
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
- Department of Psychology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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30
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Cénat JM, Dalexis RD, Guerrier M, Noorishad PG, Derivois D, Bukaka J, Birangui JP, Adansikou K, Clorméus LA, Kokou-Kpolou CK, Ndengeyingoma A, Sezibera V, Auguste RE, Rousseau C. Frequency and correlates of anxiety symptoms during the COVID-19 pandemic in low- and middle-income countries: A multinational study. J Psychiatr Res 2021; 132:13-17. [PMID: 33035760 PMCID: PMC7527178 DOI: 10.1016/j.jpsychires.2020.09.031] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/11/2020] [Accepted: 09/25/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (β = 0.06, p = .005), stigmatization related to COVID-19 (β = 0.03, p < .001), and resilience (β = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (β = 0.02, p < .00; β = 0.05, p = .013; β = 0.03, p = .021; β = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada.
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Canada
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31
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Cénat JM, Dalexis RD. The Complex Trauma Spectrum During the COVID-19 Pandemic: A Threat for Children and Adolescents' Physical and Mental Health. Psychiatry Res 2020; 293:113473. [PMID: 33198045 PMCID: PMC7534660 DOI: 10.1016/j.psychres.2020.113473] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/19/2020] [Indexed: 10/26/2022]
Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa (Vulnerability, Trauma, Resilience and Culture Research Laboratory).
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Dalexis RD, Cénat JM. Asylum seekers working in Quebec (Canada) during the COVID-19 pandemic: Risk of deportation, and threats to physical and mental health. Psychiatry Res 2020; 292:113299. [PMID: 32702554 PMCID: PMC7362783 DOI: 10.1016/j.psychres.2020.113299] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/10/2020] [Accepted: 07/12/2020] [Indexed: 10/29/2022]
Abstract
• Asylum seekers experienced childhood adversity, domestic violence, extreme poverty and precariousness, armed violence, rape, and detention. • In the context of the COVID-19 pandemic, Quebec (Canada), asylum seekers are on the frontlines, risking their lives to save the lives of others. • In addition to the anxiety associated with COVID-19, these asylum seekers are also concerned about being deported. • Regulation measures should be taken to prevent long-term mental health problems related to anxieties and worries generated by both COVID-19 and asylum status, particularly the fear of deportation.
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Cénat JM, Dalexis RD, Kokou-Kpolou CK, Mukunzi JN, Rousseau C. Social inequalities and collateral damages of the COVID-19 pandemic: when basic needs challenge mental health care. Int J Public Health 2020; 65:717-718. [PMID: 32651593 PMCID: PMC7348102 DOI: 10.1007/s00038-020-01426-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Jude Mary Cénat
- School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4085, Vanier Hall, Ottawa, ON, K1N 6N5, Canada.
| | | | | | - Joana N Mukunzi
- School of Psychology (Clinical), University of Ottawa, 136 Jean-Jacques-Lussier, 4085, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
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