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ElTohamy A, Hyun S, Rastogi R, Wong GTF, Kim GS, Chae DH, Hahm H“C, Liu CH. Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic. Psychol Trauma 2024; 16:217-224. [PMID: 37227832 PMCID: PMC10674031 DOI: 10.1037/tra0001480] [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: 05/27/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Abdelrahman ElTohamy
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ritika Rastogi
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ga Tin Finneas Wong
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Grace S. Kim
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, USA
| | - David H. Chae
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Hyeouk “Chris” Hahm
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Cindy H. Liu
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Zhang X, Wong GTF, Liu CH, Hahm HC, Chen JA. International student stressors and mental health during the COVID-19 pandemic: a qualitative study. J Am Coll Health 2022:1-7. [PMID: 35549622 DOI: 10.1080/07448481.2022.2068015] [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] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 02/25/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify stressors affecting international students' mental health during the COVID-19 pandemic. PARTICIPANTS Twenty-two international students from 10 countries and 17 US institutions participated. METHODS Participants were recruited from a larger study examining the wellbeing of young adults during the pandemic. RESULTS Four main stressors were identified: (1) Uncertainty and anxiety induced by decisions and policies in response to COVID-19; (2) Fears regarding xenophobia; (3) Limited understanding by educators and school staff of international students' unique challenges; (4) Greater awareness of racial and cultural identity. CONCLUSION The pandemic has contributed to additional stressors for international students. Educators and mental health professionals may help support international students' mental health by gaining basic knowledge about common stressors and directly acknowledging the challenges, educating international students on race and racism and supporting anti-racism efforts, and encouraging the creation of shared affinity spaces and increasing psychoeducation to promote resilience.
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Affiliation(s)
- Xiaoqiao Zhang
- School of Education, Shanghai Jiaotong University, Shanghai, China
| | - Ga Tin Finneas Wong
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Justin A Chen
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Liu CH, Wong GTF, Hyun S, Hahm H“C. Concerns about the social climate, finances, and COVID-19 risk on depression and anxiety: An analysis on U.S. young adults across two waves. J Psychiatr Res 2022; 148:286-292. [PMID: 35189512 PMCID: PMC8828372 DOI: 10.1016/j.jpsychires.2022.01.048] [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: 04/06/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 12/16/2022]
Abstract
Concerns regarding contracting COVID-19 and finances may be risks to mental health during the COVID-19 pandemic. Social climate concerns may be another risk, given U.S. protests taking place during this period. We tested the hypothesis that concerns about COVID-19 risk, finances, and social climate would predict clinically significant levels of depression, anxiety, and comorbid depression and anxiety in young adults. A total of 782 U.S. young adults (18-30 years), initially recruited through convenience sampling (social media, email listservs), completed online surveys at Wave 1 (April-August 2020) and Wave 2 (September 2020-March 2021). The primary outcomes included scoring above the cut off for depressive (PHQ-8 ≥ 10) or anxiety symptoms (GAD ≥10). Approximately 41% reported depression and 47% reported anxiety at Wave 1; rates did not differ at Wave 2. Individuals with greater financial concerns were 14% more likely to score high on depressive symptoms; those with COVID-19 risk concerns and social climate concerns were 21% and 54% more likely, respectively, to score high on generalized anxiety. Those with social climate and financial concerns were 52% and 15% more likely, respectively, to score high on comorbid depressive and anxiety symptoms. Analyses controlled for Wave 1 symptoms. We provide evidence highlighting the roles of social climate and COVID-19 risk concerns on anxiety, and financial concerns on depression in young adults. Public health campaigns should acknowledge broader societal issues that have taken place as a source of mental health distress, beyond those driven by the pandemic (e.g., isolation and lockdowns).
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Affiliation(s)
- Cindy H. Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA,Corresponding author. Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ga Tin Finneas Wong
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Liu CH, Zhang E, Hyun S, Wong GTF, Hahm HC. Health-related quality of life among US young adults during the COVID-19 pandemic: Psychiatric symptoms and emotional experiences to target within clinical practice. Ann Clin Psychiatry 2021; 33:232-240. [PMID: 34398740 DOI: 10.12788/acp.0033] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The current study aimed to determine the role of psychological experiences during the COVID-19 pandemic (depression, anxiety, loneliness, and COVID-19-related grief and worry) on young adult physical and mental health functioning as measured by health-related quality of life (HRQoL). METHODS Using hierarchical multiple regression analyses, this cross-sectional study examined psychological predictors of physical and mental health functioning among young adults (age 18 to 30 years) from April 13 to September 5, 2020. RESULTS Pre-existing depression diagnoses (beta = -0.124, P < .001), current depression symptoms (beta = -0.298, P < .001), and COVID-19-related worry (beta = -0.142, P < .001) significantly predicted poorer physical health functioning. Current depression and anxiety symptoms (beta = -0.342 and beta = -0.268), loneliness (beta = -0.135), and COVID-19-related grief (beta = -0.180) predicted lower self-reported mental health functioning (P < .001). Black (beta = -0.072) and Hispanic/Latinx participants (beta = -0.082) were more likely to indicate poorer physical health functioning (P < .01) relative to White participants, whereas women reported poorer mental health relative to men (beta = -0.047, P < .05). CONCLUSIONS This study identifies potential negative impacts of pandemic-related psychological experiences for young adults' health during the COVID-19 pandemic. There is a need to consider mental health symptomatology, COVID-19-related experiences, race, and gender when designing efforts to address long-term implications on health.
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Affiliation(s)
- Cindy H Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Emily Zhang
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ga Tin Finneas Wong
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, Boston, Massachusetts, USA
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Hyun S, Wong GTF, Levy-Carrick NC, Charmaraman L, Cozier Y, Yip T, Hahm H“C, Liu CH. Psychosocial correlates of posttraumatic growth among U.S. young adults during the COVID-19 pandemic. Psychiatry Res 2021; 302:114035. [PMID: 34139592 PMCID: PMC9754682 DOI: 10.1016/j.psychres.2021.114035] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 03/31/2021] [Accepted: 05/22/2021] [Indexed: 12/17/2022]
Abstract
Given the prolonged nature of the COVID-19 pandemic, the purpose of this study was to examine the association between posttraumatic growth (PTG) among young adults during the COVID-19 pandemic and their psychosocial characteristics, specifically: distress tolerance; resilience; family connectedness; depression, anxiety, and PTSD symptoms; and COVID-19-related worry. The study utilized data from 805 U.S. young adults (18-30 years) who completed online surveys during the COVID-19 pandemic across two waves (April-August 2020 and September 2020-March 2021). Overall, young adults reported low PTG scores. PTSD symptoms and COVID-19-related worry significantly predicted higher levels of PTG, while their depression symptoms predicted lower levels of PTG. Resilience and family connectedness significantly predicted higher levels of PTG, and distress tolerance significantly predicted lower levels of PTG after accounting for sociodemographic characteristics and negative influential factors. Compared to Whites, Asians were less likely to report PTG. In general, young adults have not perceived personal growth from the pandemic; however, young adults with certain psychosocial factors appear to be predisposed to such PTG. This study highlights the importance of exploring and elucidating the potential positive trajectories following the adversity of the COVID-19 pandemic.
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Affiliation(s)
- Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Ga Tin Finneas Wong
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | - Yvette Cozier
- School of Public Health, Boston University, Boston, MA, USA
| | - Tiffany Yip
- Psychology Department, Fordham University, Bronx, NY, USA
| | | | - Cindy H. Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA,Corresponding author at: Departments of Pediatric Newborn Medicine & Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Liu CH, Smiley PA, Vicman JM, Wong GTF, Doan SN. The roles of life stress and preventive health behaviors on parent mental health during the COVID-19 pandemic. J Health Psychol 2021; 27:1470-1483. [PMID: 34187219 DOI: 10.1177/13591053211026742] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has disrupted millions of lives, with life stress and daily hassles having a potential impact on parent mental health. This study examined whether preventive health behaviors (e.g. social distancing, mask wearing) and social support relate to parent mental health. In a cross-sectional analysis of parents (N = 176, May-September 2020), life events and daily hassles were positively associated with depressive and anxiety symptoms. Preventive health behaviors moderated the association between daily hassles and depressive symptoms. Preventive health behaviors may protect those with high levels of daily hassles from moderate levels of depression.
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Affiliation(s)
- Cindy H Liu
- Brigham and Women's Hospital, USA.,Harvard Medical School, USA
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