Positive Links Between Exposure to Police Violence, PTSD, and Depression Symptoms Among Yellow Vests Protesters in France

Exploring the impact of social protest on mental health: A study of the 2019 "Social Uprising" in Chile

Socio-political conflicts, especially if accompanied by violent events, can affect the mental health of the population. This study aimed to estimate the causal effect of social protest-related violence on depressive symptoms during the 2019 social uprising in Chile. We collected population-representative data from a nationwide longitudinal survey (n = 2918), the fourth wave of which took place during the months of the social uprising in Chile (November 2019 and March 2020). Depressive symptoms were measured using the Patient Health Questionnaire-9, while violence related to social protest was measured as the perception of destruction at the neighbourhood level. To assess the casual relationship between destruction perception and depressive symptoms, we utilized an instrumental variable regression model. Our analysis controlled for relevant sociodemographic factors, participation in social protest, and history of mental health treatment. Results showed that perceived neighbourhood destruction during the 2019 social uprising significantly increased PHQ-9 score by 3.702 points, prevalence of moderate to severe depressive symptoms by 18.7%, and likelihood of having a Subthreshold or Major Depressive Episode by 15.2% (p < 0.01). The impact of perceived destruction on depressive symptoms varies by gender, with a significant effect found in men (an increase in depression indicators of 5.769 points, 26.8% and 23.0%, respectively, p < 0.05) but not in women. Stratified regression models by age demonstrate a positive association between the perception of neighbourhood destruction and depressive symptoms across all age groups, with a stronger effect observed among young adults. We found a casual effect of violence related to social protest on depressive symptoms. These findings have implications for the planning of social policies aimed at protecting the mental well-being of the population in times of increasing socio-political turmoil.

The 50th anniversary of May 4, 1970 is associated with elevations of distress but no increase in mental health symptoms

Anniversaries of traumatic events are associated with increased symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety, especially in individuals with prior mental health symptoms. However, research has largely focussed on 1-year anniversaries, and it is unclear whether symptom exacerbation persists for more distal, or milestone, anniversaries. Symptoms typically decrease over time after traumatic events, but major anniversaries may be associated with increases in mental health symptoms. During and 3 months after the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 115 individuals completed measures of PTSD, depression, anxiety, and anniversary-related stress. Participants reported greater stress (t(97) = 4.04 p ≤ .001) during the 50th anniversary compared to 3 months later, but there were no differences in total PTSD (t(114) = .65, p = .52) or depression/anxiety symptoms (all p's > .05). Even in higher-risk individuals (those who previously received mental health services), symptoms did not differ during versus after the anniversary. In general, long-term anniversaries may contribute to transient increases in distress but do not induce major changes in mental health symptoms.

Snapshot of a social movement: Mental health and protest classes in Hong Kong

BACKGROUND

Popular protests have broken out worldwide, particularly in the last few years. In 2019, numerous demonstrations against an extradition bill occurred in Hong Kong until pandemic restrictions were imposed. The policing response relied heavily on methods such as batons, tear gas and rubber bullets. Given the relevance for other geographical contexts, the current study investigated the mental health impacts on protest participants and spillover to community members.

METHODS

Surveys were disseminated on social media in August and October 2019 to collect demographics, political views, protest participation, exposure to (protest-related) potentially traumatic events (PTEs) and mental health symptoms. A latent class analysis (LCA) was conducted using demographic data and inter-class differences in PTEs and mental health symptoms were examined.

RESULTS

There were 37,541 (59.8% female) and 40,703 (50.0% female) responses in August and October. Respondents, even those with low participation, reported significant levels of depression, anxiety, and symptoms of traumatic stress (STS). The LCA suggested a 5-class solution (youth, allies, supporters, sympathizers, and frontliners). Mental health symptoms and PTEs varied with class membership, with 50.8% of frontliners reporting severe STS.

LIMITATIONS

The non-random sampling and self-reported measures may over-estimate the prevalence of mental distress in the wider population.

CONCLUSIONS

Large numbers of pro-democracy supporters in Hong Kong reported high rates of depression, anxiety and STS during mass protests. Younger and more heavily involved respondents faced the highest mental health risks, however elevated rates were also observed for respondents with low participation.

Psychological Morbidity among University Students in Hong Kong (2014-2018): Psychometric Properties of the Depression Anxiety Stress Scales (DASS) and Related Correlates

Although mental health problems among Hong Kong university students are serious, there is a lack of studies examining the psychometric properties of related assessment scales and correlates. This study attempted to validate the Depression Anxiety Stress Scales (DASS) in Hong Kong university students and examine the demographic (gender), time (cohort), and well-being correlates (positive youth development attributes and life satisfaction) of psychological morbidity. Confirmatory factor analysis (CFA) was used to examine the factor structure of the DASS (n = 6704). Gender and cohort invariance were further established using a multigroup CFA. The three-factor model of the DASS showed a superior fit and factorial invariance across gender and five different cohorts. Regarding gender and cohort correlates of psychological morbidity, males exhibited more depression, anxiety, and stress symptoms than their female counterparts. The intensity of psychological distress also escalated after the Umbrella Movement in 2014. Furthermore, well-being measures (positive youth development and life satisfaction) were negatively associated with depression, anxiety, and stress. In short, the Chinese DASS demonstrated good psychometric properties. This study also showed that gender, cohort (occurrence of political events), and well-being were associated with psychological morbidity indexed by the DASS measures.

Health issues and healthcare utilization among adults who reported exposure to tear gas during 2020 Portland (OR) protests: a cross-sectional survey

Background

Repeated use of chemical irritants for crowd-control by local and federal law enforcement during sustained racial justice protests in the U.S. has raised concerns about potential adverse health effects. The objective of this study was to describe the health consequences of exposure to tear gas agents and associated healthcare utilization among adults reporting recent exposure to tear gas.

Methods

A cross-sectional, self-administered web-based survey of a convenience sample of 2257 adults reporting recent exposure to tear gas in Portland, Oregon (U.S.), administered between July 30, 2020-August 20, 2020. Descriptive analyses were conducted on socioeconomic characteristics, reported health issues, utilization of healthcare services, and frequency of reported exposure to tear gas. Associations between reported mental health issues, healthcare utilization and race and/or ethnic categories were assessed using a chi-square test. For tests of association, racial and/or ethnic categories were divided into White/Non-Hispanic only and all other racial/ethnic categories due to a small number of Black, American Indian or Alaska Native, Asian/Pacific Islander, Hispanic participants and participants with multiple race and/or ethnic background. Effect sizes for the differences were expressed as Cramer’s V, a metric that measures associations between nominal responses. The Cochran-Armitage trend test was used to assess the relationship between health issues and the number of reported days of exposure to tear gas (i.e., a proxy dose of exposure) grouped into 1 day, 2–4 days, and ≥ 5 days. Missing data (item non-response) were omitted from the analysis.

Results

Almost all respondents (2116; 93.8%) reported physical (2114; 93.7%) or psychological (1635; 72.4%) health issues experienced immediately after (2105; 93.3%) or days following (1944; 86.1%) the exposure. A slightly higher proportion experienced delayed head or gastrointestinal tract issues compared with immediate complaints. The majority (1233; 54.6%) reported receiving or planning to seek medical or mental care. We observed a positive exposure-response trend for all except mouth-related delayed issues (p < 0.01).

Conclusion

Persons who reported exposer to tear gas agents also reported physical and psychological health issues over a multiple-day period. Health issues reported increased with the frequency of reported exposure, indicating a potential dose-response; these health effects often led to healthcare utilization. This study provides evidence of potential unexpected harms of tear gas in civilians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10859-w.