Internalized Stigmatization, Social Support, and Individual Mental Health Problems in the Public Health Crisis

Internalized stigma: Social support, coping, psychological distress, and mental well-being among older adults in Ghana

BACKGROUND

Older adults have been found to internalize stigma from society and this has been linked to several variables including social support, coping, psychological distress, and mental well-being. However, there is a dearth of research on how these variables interact with each other to impact the life of older adults.

AIMS

This study employed path analysis to explore social support and coping as boundary conditions and underlying mechanisms in the link between internalized stigma, psychological distress, and mental well-being, among older adults in Ghana.

METHOD

Using a cross-sectional design, the study recruited 167 older adults who responded to standardized questionnaires including The Internalized Stigma of Mental Illness scale, Multidimensional Perceived Social Support Scale, The Brief Coping Inventory, Kessler Distress Scale, and the Warwick-Edinburgh Mental Well-being Scale, to determine levels of internalized stigma, social support, coping strategies, psychological distress, and mental well-being, respectively.

RESULTS

The findings revealed that at low levels of social support, there is a significant and positive correlation between internalized stigma and mental well-being (β = -.36, SE = 0.17, p < .001). Path analysis showed that the relationship between internalized stigma and mental well-being was fully mediated by problem-focused coping (β = .11, p = . 001, 95% CI [0.04, 0.21]), but not psychological distress. Problem-focused coping was also found to have a significant positive correlation with mental well-being but no significant correlation with psychological distress. Conversely, avoidant-focused coping was found to have a significant positive correlation with psychological distress and a significant negative correlation with mental well-being.

CONCLUSIONS

This study revealed the importance of social support and coping to attaining mental well-being among older adults. This study provides insights into the development of tailored interventions aimed at improving social support and problem-focused coping among older Ghanaian adults facing internalized stigma, and it also establishes a base for future research.

The link between anticipated and internalized stigma and depression: A systematic review

Stigmatized groups may experience psychological distress. Yet, some studies show no significant relation between stigma and mental health outcomes. This systematic review investigates the link between anticipated and internalized stigma, and one mental health outcome, depression. We aimed to (1) determine whether anticipated and internalized stigma predict levels of depression, and (2) review the quality of evidence for this link. We searched PsycInfo, PubMed and EMBASE databases. Eighty-three studies (N = 34,705) met our inclusion criteria, across five stigma categories: Sexual and gender minorities; HIV/AIDS; Illness or disability-related (non-HIV); Weight, and Other. We reviewed evidence within each category and study design and developed a narrative synthesis. Sixty studies (72.3%) supported the proposed link, which varied across categories from 53.6% to 100%. Using the NIH quality assessment tool, most studies were of fair quality. Most cross-sectional studies (76.7%) straightforwardly supported the positive relation between internalized and/or anticipated stigma and depression, while only 40% of longitudinal studies did. Implications for the study of stigma and mental health outcomes are discussed.

C. TB, Mandal RK, Pokharel S, Gupta R, G. C. KB. Internalized stigma related to COVID-19 and its psychosocial and mental health correlates: a multicentric health facility based observational study from Nepal

Introduction

The COVID-19 pandemic has led to physical and psychological complications and social consequences in the form of illness-related stigma. This study aimed (1) to assess the sociodemographic and clinical variable, as well as COVID-19 related knowledge and perception of persons admitted for COVID-19/Suspected COVID-19 in Nepal, (2) to determine their levels of COVID-19- related internalized stigma, depression, and anxiety symptoms, and (3) to evaluate the correlates of COVID-19- related internalized stigma.

Materials and methods

It was a cross-sectional exploratory study with a convenience sample of 395 participants (306 confirmed cases, 89 suspected cases) conducted between July-October 2020 in four health facilities in Madhesh and Lumbini provinces of Nepal. We used a semi-structured questionnaire to assess sociodemographic details, clinical information, COVID-19-related knowledge, perception, COVID-19-related internalized stigma, and the Hamilton Anxiety Depression Scale (HADS) in Nepali language. Descriptive statistics, correlation analyses, and linear regression analyses were performed. The level of statistical significance was considered at p < 0.05.

Results

Around 23.3% of the patients had anxiety symptoms, 32.9% had depressive symptoms, and 20.3% had high COVID-19-related internalized stigma (mean ISMI score: 2.51-4.00). Linear regression analyses showed a significant positive association of COVID-19-related internalized stigma total score, with the following eight factors, i.e., no income in the past one month (p = 0.013), below average socioeconomic status (p = 0.004), anxiety symptoms (p = <0.001), depressive symptoms (p = <0.001), recent testing positive for COVID-19 (p = <0.001), involuntary admission (p = <0.001), prior experience of being in isolation and quarantine (p = 0.045), and those who blame others for COVID-19 (p = 0.025).

Conclusion

COVID-19 survivors and suspects are vulnerable to symptoms of depression, anxiety, and COVID-19-related internalized stigma. For the first time from Nepal, our data suggests that COVID-19-related internalized stigma is associated with anxiety and depression symptoms, perceived below-average socioeconomic status, involuntary admission, prior experience of being in isolation and quarantine, recent COVID-19 positive report, self-blame, below-average socioeconomic status and no income in the past one month. Mitigating and preventing internalized stigma associated with a public health crisis such as COVID-19 is imperative by diagnosing and treating such mental health issues early and designing interventions and policies especially targeting vulnerable populations focusing on their economic background and socio-cultural beliefs.

Nursing Students' Attitudes Toward Seeking Psychological Help Associated to Self-Stigma and Perceived Social Stigma

Introduction

Nursing students often experience stress due to their educational demands and developmental stage. This study focuses on nursing students to investigate the relationship between their attitudes toward seeking psychological help and their levels of perceived self-stigma and social stigma.

Methods

This was a descriptive correlational study, in which 791 nursing students participated through convenience sampling between April and May 2022. Data were collected using the Attitude Towards Seeking Psychological Help Scale-R (ASPH-R), the Stigma Scale for Receiving Psychological Help (SSRPH), and the Self-Stigma of Seeking Help (SSOSH). The data were analyzed using Pearson correlation and multiple linear regression analysis. The article adheres to the STROBE checklist in its organization and presentation.

Results

Positive attitudes towards seeking psychological help were negatively correlated with self-stigma (r=-0.39, P<0.01) and social stigma perceptions (r=-0.17, P<0.01), while negative attitudes were positively correlated with self-stigma (r=0.50, P<0.01) and social stigma (r=0.47, P<0.01). Variables of sex, age, self-stigma, and social stigma significantly contributed to explaining attitudes towards seeking psychological help.

Conclusion

Social stigma and particularly self-stigma significantly influence nursing students' attitudes towards seeking psychological help. Therefore, it is recommended that authorities develop psychoeducational interventions aimed at enhancing nursing students' mental health awareness and reducing self-stigma.

The multiple mediating effect of family health and perceived social support on depressive symptoms in older adults: A cross-sectional national survey in China

BACKGROUND

Depression harms older adults' physical health and quality of life, especially for those with disabilities. This study aims to investigate the epidemiological characteristics of depressive symptoms in older adults and influencing factors involving neuroticism in China.

METHODS

A multistage random sampling method was adopted to recruit older adults. We conducted a multiple mediating analysis to explore how overall family health and perceived social support affect the relationship between neuroticism and depressive symptoms in older adults.

RESULTS

A total of 1122 older adults were included in this study, and 529 individuals reported suffering from depressive symptoms (47.1 %). Mediation analysis results indicated that neuroticism had a direct predictive effect on depressive symptoms in older adults. Family health and perceived social support partly mediated the relationship between neuroticism and depressive symptoms in older adults. Moreover, depressive symptoms in older adults with high neuroticism was directly affected by decreasing family health and indirectly and cumulatively aggravated by the mediation of lower perceived social support.

LIMITATIONS

The cross-sectional study design limits the conclusion about causation and directionality.

CONCLUSIONS

Family health and perceived social support can prevent depressive symptoms in older adults with high neuroticism.

Experienced stigma and applied coping strategies during the COVID-19 pandemic in Germany: a mixed-methods study

OBJECTIVE

Health-related stigma is considered a social determinant of health equity and a hidden burden of disease. This study aimed to assess the level and dimensions of stigma and respective coping mechanisms in COVID-19 survivors.

METHODS

A mixed-methods study with sequential explanatory design was conducted at the University Hospital of Ulm, Germany. Stigma was assessed using the Social Impact Scale (SIS) including adult COVID-19 survivors with mild-to-severe disease. Subsequently, 14 participants were sampled with regard to gender, age and severity of disease for in-depth interviews to understand how stigma was experienced and coping strategies were applied. The questionnaire was analysed using descriptive statistics, t-test and analysis of variance. Content analysis was used for qualitative data.

RESULTS

From 61 participants, 58% were men and mean age was 51 years. The quantitative analysis of the SIS indicated an intermediate level of experienced stigma. Participants experienced stigma mainly as 'social rejection' (M=14.22, SD=4.91), followed by 'social isolation' (M=10.17, SD=4.16) and 'internalised shame' (M=8.39, SD=3.32). There was no significant difference in experienced stigma regarding gender, education, occupational status or residual symptoms. However, participants between 30 and 39 years of age experienced higher levels of stigma than other age groups (p=0.034). The qualitative analysis revealed how stigma seemed to arise from misconceptions creating irrational fear of infection, leading to stereotyping, vilification, discrimination and social exclusion of COVID-19 survivors, leaving them feeling vulnerable. Stigma cut through all social levels, from the individual level at the bottom to the institutional and societal level at the top. Social networks protected from experiencing stigma.

CONCLUSION

COVID-19-related stigma is a relevant burden in the ongoing pandemic. Providing accurate information and exposing misinformation on disease prevention and treatment seems key to end COVID-19-related stigma.

Experiences, life changes, and support systems of recovered COVID-19 patients from practitioners’ perspectives: A qualitative study

The spread of COVID-19 brought a worldwide pandemic that interrupted daily life and activities. By the end of 2020, there were more than 83 million diagnosed cases and 1.8 million deaths worldwide (World Health Organization, 2020). In Wuhan, China, more than 7 million individuals were quarantined at the beginning of the pandemic. Despite the widespread impact of the pandemic, limited studies have focused on recovered COVID-19 patients’ experiences. Therefore, this qualitative study was conducted to better understand the shared experiences of recovered COVID-19 patients in Wuhan, through the lens of social work practitioners working with them. A thematic analysis of 14 individual interviews resulted in three main themes: trauma, long-term perspective change, and support systems. Recovered patients commonly reported rejection, discrimination, stigma, and self-blame as a result of having had COVID-19. Although some reported receiving social support from family members, neighbors, or employers, others reported severe rejection and maltreatment. Experiences also influenced whether patients had a more positive or negative outlook toward the future. Findings call for health care practitioners and service providers to better support COVID-19 patients using a culturally sensitive, trauma-informed approach. Neighborhood-level factors and interventions are also discussed.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

Effects of Stigma on the Relationship Between Perceived Social Support and Sexual Satisfaction Among Breast Cancer Survivors

BACKGROUND

Sexual satisfaction is one of the issues faced by breast cancer survivors (BCSs).

AIM

This study aims to explore the mediation of stigma in the relationship between perceived social support (PSS) and sexual satisfaction among breast cancer survivors.

METHODS

A cross-sectional study was conducted among 918 BCSs in Shanghai Cancer Rehabilitation Club. Data were collected using an online questionnaire including questions on sociodemographic characteristics, health status, PSS, stigma and sexual satisfaction of participants. The bootstrap method was used to test the significance of the simple mediation model.

OUTCOMES

The simple mediation of stigma was found significant in the relationship between PSS and sexual satisfaction.

RESULTS

Stigma plays an intermediary role in the relationship between 2 dimensions of PSS (family and friends) and sexual satisfaction, but not in the relationship between the dimension of other significant people of PSS and sexual satisfaction.

CLINICAL TRANSLATION

It is important to reduce stigma when improving the sexual satisfaction of BCSs from the perspective of PSS.

STRENGTHS & LIMITATIONS

The mediating role of stigma in the relationship between PSS and sexual satisfaction among BCSs has been shown for the first time. Study limitations include limitations in the representativeness of population by the study sample and the cross-sectional study design.

CONCLUSIONS

Stigma mediates the relationship between PSS and sexual satisfaction, which needs to be eliminated in intervention practice. Yuxin Zhang, Jie Zhao, Nan Jiang, et al. Effects of Stigma on the Relationship Between Perceived Social Support and Sexual Satisfaction Among Breast Cancer Survivors. J Sex Med 2022;19:1002-1011.

Development and psychometric validation of new questionnaires assessing experienced discrimination and internalised stigma among people with Covid-19

AIMS

To develop and validate two new standardised measures assessing, respectively, experienced discrimination (Covid-19 Experienced DISCrimination scale, CEDISC) and internalised stigma (COvid-19 INternalised Stigma scale, COINS) in people who had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or had developed coronavirus disease 2019 (Covid-19) disease.

METHODS

Both the CEDISC and the COINS were developed in Italian and tested for ease of use, comprehension, acceptability, the relevance of items and response options within a focus group session. Online cross-sectional validation survey was conducted among adults infected with SARS-CoV-2 or who developed Covid-19 disease, members of a closed Facebook discussion group in Italy. Exploratory factor analysis (EFA) with Promax oblique rotation; the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and the Bartlett's test of sphericity were used to assess the suitability of the sample for factor analysis. Reliability was assessed as internal consistency using Cronbach's alpha and as test-retest reliability using weighted kappa and intraclass correlation coefficient (ICC). Precision was examined by Kendall's tau-b coefficient.

RESULTS

Overall, 579 participants completed the CEDISC, 519 also completed the COINS, 155 completed the retest for both scales after two weeks. The 12 items of the CEDISC converged over a 2-factor solution ('social life' and 'close relations') accounting for 49.2% of the variance (KMO = 0.894; Bartlett's test p < 0.001); the 13 items of the COINS converged over a 3-factor solution ('self-perception', 'close relations' and 'social life') accounting for 67.7% (KMO = 0.827; Bartlett's test p < 0.001). Cronbach's α was 0.848 for the CEDISC, and 0.837 for the COINS. The CEDISC showed three items (25%) with kappa between 0.61 and 0.80 and seven (58.4%) between 0.41 and 0.60, with only two items scoring 0.21 and 0.40; the COINS had ten items (76.9%) with kappa ranging from 0.41 to 0.60, and three items below 0.31. ICC was 0.906 (95% CI, 0.871-0.932) for the, CEDISC and 0.860 (95% CI, 0.808-0.898) for the COINS. Kendall's tau-b ranged from 0.360 to 0.556 (p < 0.001) for the CEDISC and from 0.290 to 0.606 (p < 0.001) for the COINS.

CONCLUSIONS

Both the CEDISC and the COINS are two valid and reliable scales to be used in studies examining the role of stigma and discrimination of people infected with SARS-CoV-2 and Covid-19 patients, and in research evaluating interventions designed to mitigate stigma in this population.

COVID-19 Induced Economic Slowdown and Mental Health Issues

The COVID-19 pandemic has pressed a pause button on global economic development, and induced significant mental health problems. In order to demonstrate the progressed relationship between the pandemic, economic slowdown, and mental health burden, we overviewed the global-level gross domestic product changes and mental problems variation since the outbreak of COVID-19, and reviewed comprehensively the specific sectors influenced by the pandemic, including international trade, worldwide travel, education system, healthcare system, and individual employment. We hope to provide timely evidence to help with the promotion of policymakers’ effective strategies in mitigating economic losses induced by the pandemic; we suggest different governments or policy makers in different countries to share information and experience in dealing with COVID-19-induced economic slowdown and promote COVID-19 vaccine popularization plan to protect every individual worldwide against the coronavirus essentially; and we appeal international information share and collaboration to minimize stigmatization related to adverse mental consequences of COVID-19 and to increase mental health wellbeings of people all over the world.

Associations between accessibility to health care service, social support, and Korean Americans' mental health status amid the COVID-19 pandemic

Background

While previous studies have examined the relationships between social support and health care accessibility among ethnic minority populations, studies on Korean Americans remain scarce. Therefore, this study aims to assess the relationship between Korean Americans’ mental health, accessibility to health care, and how they perceive the level of social support during the COVID-19 pandemic.

Method/result

We distributed online surveys to Korean Americans from May 24, 2020, to June 14, 2020, generating 790 responses from participants residing in 42 states. Binary Logistic and Ordinary Least Square regression analyses revealed that poor mental health was associated with language barriers inhibiting Korean Americans’ access to COVID-19-related information. Their perceived social support from family members and close friends was positively associated with mental health.

Conclusion

Our findings recommend that equipping community health care services with translators or interpreters is necessary. Additionally, health practitioners and staff should be trained to utilize telehealth tools to effectively treat individuals with mental health problems. American policymakers and health care professionals need to understand and address the unique hardships Korean Americans experience amid COVID-19.

Racial Discrimination as a Cumulative Risk Factor Affecting Parental Stress on the Psychological Distress of Korean Americans (Both US- and Foreign-Born) amid COVID-19: Structural Equation Modeling

This study examined the relationships of parental stress and racial discrimination to the psychological distress of Korean Americans (both US- and foreign-born) during the COVID-19 pandemic. It also explored whether racial discrimination moderated the effect of parental stress on psychological distress. Using primary data collected between May 24, 2020, and June 14, 2020, via an online questionnaire, confirmatory factor analysis and structural equation models were conducted on 339 Korean American parents. Results indicated that parental stress and racial discrimination were associated with parental psychological distress. However, when the sample was divided by parental sex, racial discrimination played as a moderator, the interaction of discrimination, and parenting stress was associated with more psychological distress only for mothers. Based on the study results, we recommended that policymakers should consider policies and programs that can reduce racism to make up for the public health crisis associated with COVID-19; clinical practitioners also need to provide appropriate virtual mental/physical health services and interventions that can decrease parental stress and psychological distress amid COVID-19.

Negative Emotion Arousal and Altruism Promoting of Online Public Stigmatization on COVID-19 Pandemic

The outbreak of COVID-19 is a public health crisis that has had a profound impact on society. Stigma is a common phenomenon in the prevalence and spread of infectious diseases. In the crisis caused by the pandemic, widespread public stigma has influenced social groups. This study explores the negative emotions arousal effect from online public stigmatization during the COVID-19 pandemic and the impact on social cooperation. We constructed a model based on the literature and tested it on a sample of 313 participants from the group being stigmatized. The results demonstrate: (1) relevance and stigma perception promote negative emotions, including anxiety, anger, and grief; (2) the arousal of anger and grief leads to a rise in the altruistic tendency within the stigmatized group; and (3) stigmatization-induced negative emotions have a complete mediating effect between perceived relevance and altruistic tendency, as well as perceived stigma and altruistic tendency. For a country and nation, external stigma will promote the group becoming more united and mutual help. One wish to pass the buck but end up helping others unintentionally. We should not simply blame others, including countries, regions, and groups under the outbreak of COVID-19, and everyone should be cautious with the words and actions in the Internet public sphere.

COVID-19-Related Intolerance of Uncertainty and Mental Health among Back-To-School Students in Wuhan: The Moderation Effect of Social Support

The current wave and future trend of the novel coronavirus disease 2019 (COVID-19) has triggered public uncertainty, causing unbearable psychological pressure on people. A cross-sectional online questionnaire was conducted among back-to-school students in Wuhan from 31 August 2020, to 14 September 2020, by using convenience sampling. A total of 1017 participants voluntarily provided sociodemographic characteristics and accomplished the following scales: the Intolerance of Uncertainty Scale (IUS-12), the Social Support Scale (SSQ), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index-7 (ISI-7). Results revealed that the levels of anxiety, depression, and insomnia were moderate, moderate and subthreshold, respectively. A one-way multivariate analysis of variance indicated that those with different attitudes toward the trajectory of the COVID-19 epidemic in China showed significantly different results in anxiety and depression (p < 0.001). Moderation modeling implicated that social support significantly moderated the predictive relationship between intolerance of uncertainty and mental health variables including anxiety and depression, but failed on insomnia. Findings indicate that back-to-school students in Wuhan experience mental health problems and improving social support measures could buffer the effect of intolerance of uncertainty with respect to COVID-19 on mental health.

The Mediating Role of Internalized Stigma and Shame on the Relationship between COVID-19 Related Discrimination and Mental Health Outcomes among Back-to-School Students in Wuhan

Outbreaks of an epidemic, such as coronavirus disease 2019 (COVID-19), always brings about far-ranging discrimination and stigmatization to the epicenter. This was a cross-sectional survey conducted to assess experienced discrimination, internalized stigma, shame, and mental health (anxiety, depression, distress, insomnia) among college students who merely had a perceived linkage with COVID-19, and explore the linkage between discrimination and negative mental health outcomes through the mediating effects of shame and internalized stigma. A total of 995 participants (53% female) were involved in this study, in which 40.9% of college students were reported to be discriminated against because of their experience in Wuhan. The experience of COVID-19-related discrimination is indirectly associated with anxiety, depression, and insomnia, in which shame and internalized stigma play a complete mediating effect. Meanwhile, it is both directly and indirectly associated with distress through shame and internalized stigma. The findings of this study suggest that COVID-19-related discrimination is associated with shame and internalized stigma, which in turn predict psychological symptoms over time.

Heterogeneous Influences of Social Support on Physical and Mental Health: Evidence from China

Employing a national representative survey (the China Labor-force Dynamics Survey 2016, CLDS2016) data (N = 14246), this paper examines the heterogeneous influences of social support on individual physical and mental health in China. Social support is characterized by four dimensions: emotional support, tangible or instrumental support, interaction or exchange support, and community support. Physical health is measured by self-rated health and body mass index (BMI), while mental health is measured by depression, hopelessness, failure, fear, loneliness, and meaninglessness. The results indicate that different dimensions of social support have heterogeneous effects on individual physical and mental health. Specifically, the correlation between emotional support and individual physical health is not significant, but emotional support is significantly related to some mental health variables. Tangible or instrumental support is significantly related to individual self-rated physical health but not to BMI or mental health. Interaction or exchange support is significantly correlated with individual self-rated health and some mental health variables. In general, there are significant correlations between community support, and individual physical and mental health. The results also suggest that the influences of social support on physical and mental health of individuals at different ages (<60 years and ≥60 years) are heterogeneous. The results of this study provide direction for the dimension selection of social support to promote individual health.

Predicting Psychological Distress Amid the COVID-19 Pandemic by Machine Learning: Discrimination and Coping Mechanisms of Korean Immigrants in the U.S

The current study examined the predictive ability of discrimination-related variables, coping mechanisms, and sociodemographic factors on the psychological distress level of Korean immigrants in the U.S. amid the COVID-19 pandemic. Korean immigrants (both foreign-born and U.S.-born) in the U.S. above the age of 18 were invited to participate in an online survey through purposive sampling. In order to verify the variables predicting the level of psychological distress on the final sample from 42 states (n = 790), the Artificial Neural Network (ANN) analysis, which is able to examine complex non-linear interactions among variables, was conducted. The most critical predicting variables in the neural network were a person's resilience, experiences of everyday discrimination, and perception that racial discrimination toward Asians has increased in the U.S. since the beginning of the COVID-19 pandemic.