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
Abstract
:1. Introduction
2. Methods
2.1. Setting and Participants
2.2. Procedure
2.3. Measures
2.4. Common Method Bias
2.5. Data Analysis
3. Results
3.1. Characteristics of Participants
3.2. Correlation between Variables
3.3. Mediating Effect Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Categories | n | % |
---|---|---|---|
Sex | Male | 463 | 46.53 |
Female | 532 | 53.47 | |
Age | 18–21 | 421 | 42.31 |
22–25 | 501 | 50.35 | |
26–29 | 63 | 6.33 | |
30 and above | 10 | 1.01 | |
Years expected to graduate | Within 1 year | 339 | 34.07 |
Within 2 years | 328 | 32.96 | |
Within 3 years | 240 | 24.12 | |
4 years and above | 88 | 8.84 | |
Have you ever been discriminated against because of your experience in Wuhan? | Yes | 407 | 40.90 |
No | 588 | 59.10 | |
Source of discrimination | Community | 312 | 76.66 |
Friends and relatives around | 221 | 54.30 | |
Social Media | 134 | 32.92 | |
Restaurants, hotels, hospitals, and other facilities | 90 | 22.11 | |
Administrative Departments and law enforcement agencies | 90 | 22.11 | |
Railway transportation and airport department | 55 | 13.51 | |
Form of discrimination | Social avoidance | 277 | 68.06 |
Personal information leakage | 220 | 54.05 | |
Abusive expressions | 187 | 45.95 | |
Deliberately complicated examination procedure | 157 | 38.57 | |
Others | 19 | 4.67 | |
Body conflicts | 17 | 4.18 |
Variable | M | SD | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
---|---|---|---|---|---|---|---|---|---|
1. Discrimination | 1 | ||||||||
2. Shame | 8.24 | 4.74 | 0.116 *** | 1 | |||||
3. Internalized stigma | 36.37 | 12.45 | 0.390 *** | 0.406 *** | 1 | ||||
4. Anxiety | 11.38 | 4.30 | 0.084 ** | 0.300 ** | 0.270 *** | 1 | |||
5. Distress | 15.84 | 4.98 | 0.175 *** | 0.316 *** | 0.351 *** | 0.443 *** | 1 | ||
6. Depression | 14.21 | 5.18 | 0.099 ** | 0.334 *** | 0.279 *** | 0.716 *** | 0.454 *** | 1 | |
7. Insomnia | 13.80 | 5.50 | 0.101 ** | 0.282 *** | 0.265 *** | 0.518 *** | 0.441 *** | 0.641 *** | 1 |
Regression Model | Fitting Index | Significance of Coefficients | ||||
---|---|---|---|---|---|---|
Outcome Variable | Independent Variable | R | R2 | F | β | t |
Shame | Sex | 0.1502 | 0.0226 | 5.712 | −1.0219 | −3.4045 |
Age | 0.5129 | 2.1465 * | ||||
YEG | −0.083 | −0.5266 | ||||
Discrimination | 0.7683 | 2.5197 * | ||||
Internalized Stigma | Sex | 0.5934 | 0.3521 | 107.515 | 0.4303 | 0.6666 |
Age | 2.0311 | 3.9665 *** | ||||
YEG | −0.0816 | −0.2421 | ||||
Discrimination | 7.811 | 11.9435 *** | ||||
Shame | 1.1975 | 17.6241 *** | ||||
Anxiety | Sex | 0.3969 | 0.1575 | 30.795 | 0.359 | 1.4108 |
Age | −0.2052 | −1.0089 | ||||
YEG | −0.2428 | −1.8277 | ||||
Discrimination | 0.0391 | 0.1418 | ||||
Shame | 0.2636 | 8.5866 *** | ||||
Internalized sigma | 0.0552 | 4.4006 *** | ||||
Distress | Sex | 0.4207 | 0.177 | 35.408 | 0.1259 | 0.4321 |
Age | 0.0476 | 0.2045 | ||||
YEG | −0.4952 | −3.2545 ** | ||||
Discrimination | 0.7698 | 2.4375 * | ||||
Shame | 0.2536 | 7.2125 *** | ||||
Internalized stigma | 0.0787 | 5.4841 *** | ||||
Depression | Sex | 0.4487 | 0.2014 | 41.518 | 0.8699 | 2.9115 ** |
Age | 0.1959 | 0.82 | ||||
YEG | −0.3077 | −1.973 * | ||||
Discrimination | 0.0594 | 0.1836 | ||||
Shame | 0.3848 | 10.6758 *** | ||||
Internalized stigma | 0.0569 | 3.8697 *** | ||||
Insomnia | Sex | 0.4036 | 0.1629 | 32.042 | 0.561 | 1.7289 |
Age | 1.0709 | 4.1285 *** | ||||
YEG | −0.0996 | −0.588 | ||||
Discrimination | 0.1528 | 0.4347 | ||||
Shame | 0.3038 | 7.7609 *** | ||||
Internalized stigma | 0.067 | 4.1921 *** |
Model | Path | Effect | Boot SE | Boot 95%CI | Effect Size |
---|---|---|---|---|---|
D on anxiety | Direct effect | 0.0391 | 0.2757 | −0.5020, 0.5802 | 5.41% |
Indirect effect | |||||
Total | 0.6841 | 0.1529 | 0.3889, 0.9918 | 94.59% | |
D→S→Anxiety | 0.2025 | 0.0887 | 0.0361, 0.3899 | 28.00% | |
D→IS→Anxiety | 0.4308 | 0.1127 | 0.2204, 0.6633 | 59.57% | |
D→S→IS→Anxiety | 0.0507 | 0.0254 | 0.008, 0.1077 | 7.01% | |
D on distress | Direct effect | 0.7689 | 0.3158 | 0.1501, 1.3896 | 46.54% |
Indirect effect | |||||
Total | 0.8822 | 0.1795 | 0.5511, 1.2642 | 53.40% | |
D→S→Distress | 0.1949 | 0.0822 | 0.0411, 0.3669 | 11.80% | |
D→IS→Distress | 0.6149 | 0.132 | 0.3761, 0.8908 | 37.22% | |
D→S→IS→Distress | 0.0724 | 0.0366 | 0.0141, 0.1597 | 4.38% | |
D on depression | Direct effect | 0.0594 | 0.3238 | −0.5759, 0.6948 | 6.97% |
Indirect effect | |||||
Total | 0.7929 | 0.1904 | 0.4261, 1.1704 | 93.03% | |
D→S→Depression | 0.2957 | 0.1266 | 0.0516, 0.5541 | 34.69% | |
D→IS→Depression | 0.4448 | 0.126 | 0.2046, 0.7034 | 52.19% | |
D→S→IS→Depression | 0.0524 | 0.0272 | 0.0077, 0.1135 | 6.15% | |
D on insomnia | Direct effect | 0.1528 | 0.3516 | −0.5372, 0.8428 | 15.73% |
Indirect effect | |||||
Total | 0.8184 | 0.1954 | 0.458, 1.2168 | 84.27% | |
D→S→Insomnia | 0.2334 | 0.1025 | 0.0482, 0.4457 | 24.03% | |
D→IS→Insomnia | 0.5233 | 0.1435 | 0.2567, 0.8183 | 53.88% | |
D→S→IS→Insomnia | 0.0616 | 0.0325 | 0.0107, 0.1367 | 6.34% |
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Li, H.; Zheng, L.; Le, H.; Zhuo, L.; Wu, Q.; Ma, G.; Tao, H. 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. Int. J. Environ. Res. Public Health 2020, 17, 9237. https://doi.org/10.3390/ijerph17249237
Li H, Zheng L, Le H, Zhuo L, Wu Q, Ma G, Tao H. 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. International Journal of Environmental Research and Public Health. 2020; 17(24):9237. https://doi.org/10.3390/ijerph17249237
Chicago/Turabian StyleLi, Hao, Ling Zheng, Hong Le, Lijun Zhuo, Qian Wu, Guoqing Ma, and Hongbing Tao. 2020. "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" International Journal of Environmental Research and Public Health 17, no. 24: 9237. https://doi.org/10.3390/ijerph17249237