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Immigration, Educational Attainment, and Subjective Health in the United States. 美国的移民、教育程度和主观健康状况。
Pub Date : 2024-01-01 Epub Date: 2024-01-05 DOI: 10.29245/2578-2959/2024/1.1299
Rifath Ara Alam Barsha, Babak Najand, Hossein Zare, Shervin Assari

Objectives: Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups. While we know more about marginalization due to race and ethnicity, limited information is available on MDRs of educational attainment among US immigrant individuals.

Aims: This study compared immigrant and non-immigrant US adults aged 18 and over for the effects of educational attainment on subjective health (self-rated health; SRH).

Methods: Data came from General Social Survey (GSS) that recruited a nationally representative sample of US adults from 1972 to 2022. Overall, GSS has enrolled 45,043 individuals who were either immigrant (4,247; 9.4%) and non-immigrant (40,796; 90.6%). The independent variable was educational attainment, the dependent variable was SRH (measured with a single item), confounders were age, gender, race, employment and marital status, and moderator was immigration (nativity) status.

Results: Higher educational attainment was associated with higher odds of good SRH (odds ratio OR = 2.08 for 12 years of education, OR = 2.81 for 13-15 years of education, OR = 4.38 for college graduation, and OR = 4.83 for graduate studies). However, we found significant statistical interaction between immigration status and college graduation on SRH, which was indicative of smaller association between college graduation and SRH for immigrant than non-immigrant US adults.

Conclusions: In line with MDRs, the association between educational attainment and SRH was weaker for immigrant than non-immigrant. It is essential to implement two sets of policies to achieve health inequalities among immigrant populations: policies that increase educational attainment of immigrants and those that increase the health returns of educational attainment for immigrants.

目标:尽管受教育程度是健康的一个主要社会决定因素,但根据边缘化相关收益递减(MDRs)理论,与特权群体相比,教育对边缘化群体的影响往往较弱。虽然我们对种族和民族造成的边缘化有更多了解,但有关美国移民受教育程度的 MDRs 信息却很有限:数据来自 1972 年至 2022 年期间对美国成年人进行的具有全国代表性的抽样调查(GSS)。总体而言,GSS 共登记了 45,043 人,其中有移民(4,247 人,占 9.4%)和非移民(40,796 人,占 90.6%)。自变量是受教育程度,因变量是性健康和生殖健康(用一个项目衡量),混杂因素是年龄、性别、种族、就业和婚姻状况,调节因素是移民(原籍)身份:教育程度越高,性健康和生殖健康状况越好的几率越高(12 年教育程度的几率比为 2.08,13-15 年教育程度的几率比为 2.81,大学毕业的几率比为 4.38,研究生毕业的几率比为 4.83)。然而,我们发现移民身份与大学毕业对性健康和生殖健康的影响在统计学上有明显的交互作用,这表明与非移民相比,移民美国成年人的大学毕业与性健康和生殖健康之间的关系较小:结论:与 MDRs 一致,移民受教育程度与性健康和生殖健康之间的关系弱于非移民。必须实施两套政策来实现移民人口的健康不平等:提高移民受教育程度的政策和提高移民受教育程度的健康回报的政策。
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引用次数: 0
Exposure to Adverse Life Events among Children Transitioning into Adolescence: Intersections of Socioeconomic Position and Race. 步入青春期的儿童遭遇的不良生活事件:社会经济地位与种族的交叉。
Pub Date : 2024-01-01 Epub Date: 2024-01-04 DOI: 10.29245/2578-2959/2024/1.1293
Shervin Assari, Babak Najand, Alexandra Donovan

Background: Racism is shown to diminish the protective effects of family socioeconomic position (SEP) resources for racial minorities compared to the majority groups, a pattern called minorities' diminished returns. Our existing knowledge is minimal about diminished returns of family SEP indicators on reducing exposure to adverse life events among children transitioning into adolescence.

Aim: To compare diverse racial groups for the effects of family income and family structure on exposure to adverse life events of pre-adolescents transitioning to adolescence.

Methods: In this longitudinal study, we analyzed data from 22,538 observations belonging to racially diverse groups of American 9-10-year-old children (n = 11,878) who were followed while transitioning to adolescence. The independent variables were family income and family structure. The primary outcome was the number of stressful life events with impact on adolescents, measured by the Life History semi-structured interview. Mixed-effects regression models were used for data analysis to adjust for data nested to individuals, families, and centers.

Results: Family income and married family structure had an overall inverse association with children's exposure to adverse life events during transition to adolescence. However, race showed significant interactions with family income and family structure on exposure to adverse life events. The protective effects of family income and married family structure were weaker for African American than White adolescents. The protective effect of family income was also weaker for mixed/other race than White adolescents.

Conclusion: While family SEP is protective against children's exposure to adverse life events, this effect is weaker for African American and mixed/other race compared to White youth.

背景:与多数群体相比,种族主义会削弱家庭社会经济地位(SEP)资源对少数种族群体的保护作用,这种模式被称为 "少数群体收益递减"。目标:比较不同种族群体的家庭收入和家庭结构对即将步入青春期的学龄前儿童遭遇不良生活事件的影响:在这项纵向研究中,我们分析了22,538名美国9-10岁儿童(n = 11,878)中不同种族群体的观察数据,这些儿童在向青春期过渡时接受了跟踪调查。自变量为家庭收入和家庭结构。主要结果是对青少年产生影响的生活压力事件的数量,通过 "生活史 "半结构化访谈进行测量。数据分析采用混合效应回归模型,以调整嵌套于个人、家庭和中心的数据:结果:家庭收入和已婚家庭结构与儿童在向青春期过渡期间遭遇的不良生活事件总体呈反向关系。然而,种族与家庭收入和家庭结构对不良生活事件的影响有明显的交互作用。对于非裔美国青少年来说,家庭收入和已婚家庭结构的保护作用要弱于白人青少年。家庭收入对混血/其他种族青少年的保护作用也弱于白人青少年:结论:虽然家庭收入和已婚家庭结构对儿童遭遇不利生活事件具有保护作用,但与白人青少年相比,这种作用对非洲裔美国人和混血/其他种族青少年的影响较弱。
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引用次数: 0
A New Approach to Testing Patients in Acute Psychiatric Hospitals 急性精神病医院病人检测的新方法
Pub Date : 2022-02-02 DOI: 10.29245/2578-2959/2022/1.1243
Connor H. G. Patros, M. Genovese
First, patients in these settings often present with what are known as high severity problems, such as suicidal thoughts and behaviors, acute substance use disorders, and psychosis. In conjunction with these issues, it is not uncommon for patients to be admitted into acute psychiatric hospitals involuntarily. Amidst such high severity, complex difficulties it can become extremely challenging for individuals to accurately report on their own behavioral and emotional challenges, leading self-report surveys to be limited in their utility. As a result, acquiring valid data that can be used to quantify the degree of their pathology and progress in treatment has been challenging.
首先,这些环境中的患者通常表现出所谓的严重问题,如自杀念头和行为、急性物质使用障碍和精神病。结合这些问题,病人被非自愿地送入急性精神病医院并不罕见。在如此严重、复杂的困难中,个体准确地报告自己的行为和情感挑战可能变得极具挑战性,导致自我报告调查的效用受到限制。因此,获取可用于量化其病理程度和治疗进展的有效数据一直具有挑战性。
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引用次数: 0
Letter to the Editor: The Link Between Covid-19-Induced Mental Health Complications And Microbiota Can Exist 致编辑的信:covid -19引起的心理健康并发症和微生物群之间的联系可能存在
Pub Date : 2021-07-26 DOI: 10.29245/2578-2959/2021/3.1237
G. Tevzadze, E. Zhuravliova, D. Mikeladze
© 2021 Mikeladze D. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. There have been recent reports of mental complications caused by COVID-19. Scientific evidence, on the one hand, tells about the effect that COVID-19 has on mental health directly, as well as the indirect effect that COVID-19 has on people in quarantine, with mental health problems and health care personnel1.
©2021 Mikeladze D.本文基于知识共享署名4.0国际许可协议发布。最近有报道称,COVID-19引起了精神并发症。一方面,科学证据说明了COVID-19对心理健康的直接影响,以及COVID-19对隔离人群、精神健康问题患者和卫生保健人员的间接影响。
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引用次数: 0
Diminished Effect of Smoking Intensity on African American and Latino Smokers’ Tobacco Risk Perception 吸烟强度对非裔美国人和拉丁裔吸烟者烟草风险认知的影响减弱
Pub Date : 2021-07-17 DOI: 10.29245/2578-2959/2021/3.1233
S. Assari
Background: According to the Minorities’ Diminished Returns (MDRs), highly educated African American (AA) and Latino people remain at high risk of tobacco use. One hypothesis suggests that this high risk of tobacco use stems from AA and Latino people remaining unrealistically optimistic, resulting in the risks of tobacco use being discounted. Aims: To better understand the role of cognitive bias as a mechanism behind the high risk of smoking in highly educated minorities, we studied ethnic variation in the association between smoking intensity and perceiving oneself as a smoker among young American adult established current smokers. Methods: In this cross-sectional study, we used baseline data of 2,475 young adults (18-24 years) who were current established smokers. The data came from the Population Assessment of Tobacco and Health (PATH; 2013) study, a nationally representative survey in the US. The independent variable was smoking intensity. The dependent variable was not perceiving oneself as a smoker (probably due to optimistic cognitive bias and discounting the risk). Age, gender, and education were the covariates. Ethnicity was the moderator. Logistic regressions were used to analyze the data. Results: From the total number of 2,475 current smokers, 2106 (85.1%) perceived themselves-as a smoker, and 369 (14.9%) smokers perceived themselves as a non-smoker. A high level of smoking intensity was associated with lower odds of not perceiving oneself as a smoker. Two significant interactions were found between Latino and AA ethnicity and smoking intensity, suggesting that the effect of smoking intensity on perceiving oneself as a smoker is weaker in AAs than Whites and Latinos than non-Latinos. Conclusions:While tobacco use intensity is associated with a lower likelihood of optimistic cognitive bias and not perceiving oneself as a smoker, Latino and AA young adults who smoke many cigarettes a day are more likely than their non-Latino White counterparts with the same smoking risk not to perceive themself as a smoker. This finding suggests a psychological discounting of risk among AA and Latino smokers. Such cognitive bias may help them avoid cognitive dissonance and reduce their own perceived risk of cancer and other fatal conditions from smoking. A cognitive bias may increase the smoking burden of AA and Latino young adults through discounting smoking risk.
背景:根据少数民族的减少回报(mdr),受过高等教育的非洲裔美国人(AA)和拉丁裔人仍然处于烟草使用的高风险中。一种假设认为,这种高烟草使用风险源于嗜酒者协会和拉丁裔人保持不切实际的乐观,导致烟草使用的风险被低估。目的:为了更好地理解认知偏差作为高学历少数群体吸烟高风险背后的机制所起的作用,我们研究了美国年轻成年吸烟者中吸烟强度与自我认知之间关系的种族差异。方法:在这项横断面研究中,我们使用了2475名目前已确定吸烟的年轻人(18-24岁)的基线数据。数据来自烟草与健康人口评估(PATH;2013)研究,这是美国一项具有全国代表性的调查。自变量为吸烟强度。因变量是不认为自己是吸烟者(可能是由于乐观的认知偏见和对风险的低估)。协变量为年龄、性别和教育程度。种族是调节因素。采用Logistic回归对数据进行分析。结果:在2475名吸烟者中,2106名(85.1%)吸烟者认为自己是吸烟者,369名(14.9%)吸烟者认为自己不吸烟。高水平的吸烟强度与不认为自己是吸烟者的几率较低有关。在拉丁裔和非拉丁裔种族和吸烟强度之间发现了两个显著的相互作用,这表明吸烟强度对吸烟自我感知的影响在非拉丁裔和拉丁裔中比白人弱。结论:虽然烟草使用强度与乐观认知偏差和不认为自己是吸烟者的可能性较低有关,但每天吸烟许多支的拉丁裔和AA年轻人比具有相同吸烟风险的非拉丁裔白人更有可能不认为自己是吸烟者。这一发现表明,嗜酒者互戒协会和拉丁裔吸烟者在心理上低估了风险。这种认知偏差可能会帮助他们避免认知失调,降低他们自己因吸烟而患癌症和其他致命疾病的风险。认知偏差可能通过低估吸烟风险而增加嗜酒者和拉丁裔年轻人的吸烟负担。
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引用次数: 1
From Research to Practice: Designing a Treatment Program for Individuals Convicted of Child Sexual Exploitation Material 从研究到实践:为儿童性剥削材料被定罪的个人设计治疗方案
Pub Date : 2021-06-02 DOI: 10.29245/2578-2959/2021/2.1236
A. Azizian
The term evidence-based is increasingly found in treatment manuals and program titles designed for individuals convicted of a sexual offense. However, whether the presented evidence truly qualifies as “evidence-based” is questionable. I will share my experience as the clinical director for a private outpatient agency where we designed a program based on the existing peer-reviewed literature on individuals convicted of Child Sexual Exploitation Material (CSEM) offenses. I will describe the steps that we followed in developing a workgroup to explore and apply the knowledge from research to our clinical practice. We adapted the term evidence-informed to acknowledge that the program relied on existing literature in combination with the experiences and expertise of our clinical team. A fictitious case that reflects an amalgamation of facts is presented to demonstrate the assessment and treatment processes. Implications for organizational consensus to conduct program evaluation and research are discussed.
“循证”一词越来越多地出现在治疗手册和为性侵犯罪犯设计的项目标题中。然而,所提出的证据是否真正符合“基于证据”的标准是值得怀疑的。我将分享我作为一家私人门诊机构的临床主任的经验,我们在那里设计了一个项目,该项目基于现有的同行评审文献,内容是关于被判犯有儿童性剥削材料(CSEM)罪行的个人。我将描述我们在建立一个工作组来探索和应用研究中的知识到我们的临床实践中所遵循的步骤。我们修改了“循证”一词,以承认该项目依赖于现有文献,并结合我们临床团队的经验和专业知识。一个虚构的情况下,反映了事实的合并提出,以展示评估和处理过程。讨论了组织共识对进行项目评估和研究的影响。
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引用次数: 0
Mental Health Stigma Among Black Immigrant Women in An Urban Setting. 黑人移民妇女在城市环境中的心理健康问题
Aderonke Bamgbose Pederson, Valerie Earnshaw, Crystal T Clark, Katelyn Zumpf, Inger Burnett-Zeigler

Background: Mental health stigma results in unmet mental health needs. Research describing predictors of stigma remains limited among Black immigrants. We aim to examine stigma associated with mental illness among a group of Black immigrant women.

Methods: We examined data from 22 women from two Black immigrant community centers. We collected surveys on demographics, cultural beliefs, migration status, religiosity and mental health stigma. Simple linear regression was used to model the unadjusted association between each component variable and overall stigma scores. All analyses were conducted using R and assumed a two-sided, 5% level of significance.

Results: A linear relationship was found between author-generated scale, the Stigma and Culture Survey (SCS) and the Depression Self Stigma Scale (DSSS). Among respondents, use of religious resources was associated with less stigma (p-value: 0.04). Whereas spirituality and morality was associated with greater stigma (p-value: 0.003). United States citizenship was associated with less stigma (p-value: 0.0001).

Discussion/conclusion: Religion and spirituality are critical to understanding mental health stigma among Black immigrants. Studies aimed at assessing and reducing stigma need to critically engage with cultural and religious factors.

背景:心理健康污名导致心理健康需求未得到满足。描述黑人移民中耻辱的预测因素的研究仍然有限。我们的目标是在一群黑人移民妇女中研究与精神疾病相关的耻辱。方法:我们检查了来自两个黑人移民社区中心的22名妇女的数据。我们收集了关于人口统计、文化信仰、移民身份、宗教信仰和心理健康耻辱的调查。采用简单线性回归对各成分变量与总体病耻感评分之间的未经调整的相关性进行建模。所有分析均使用R进行,并假设双侧显著性水平为5%。结果:作者生成量表、病耻感与文化调查(SCS)和抑郁症自我病耻感量表(DSSS)之间存在显著的线性关系。在被调查者中,宗教资源的使用与较少的耻辱相关(p值:0.04)。而精神和道德与更大的耻辱感相关(p值:0.003)。美国国籍与较少的耻辱感相关(p值:0.0001)。讨论/结论:宗教和灵性是理解黑人移民心理健康耻辱的关键。旨在评估和减少耻辱的研究需要批判性地考虑文化和宗教因素。
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引用次数: 0
A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States. 美国非裔美国人减少精神疾病污名化干预的叙述性回顾。
Pub Date : 2021-01-01 Epub Date: 2021-06-23 DOI: 10.29245/2578-2959/2021/2.1235
Kevin J Rivera, Jenny Y Zhang, David C Mohr, Annie B Wescott, Aderonke Bamgbose Pederson

Among African Americans, the chronicity and severity of mental illness correlates with worse health outcomes and widens health disparities. Stigma related to mental illness compounds mental health disparities by creating barriers to help-seeking behavior. We examine the current tools designed to reduce mental illness stigma and promote improved mental health outcomes among African Americans. The authors reviewed the current evidence in the literature for such stigma reduction interventions. The review team developed a focused search across four databases: PubMed, Embase, Scopus, and APA PsycINFO. Initial searches identified 120 articles, from which six studies were included as reporting on mental illness stigma reduction interventions among African Americans. We describe these four quantitative and two qualitative studies. There have been various interventions used among African Americans to reduce mental illness stigma, and the level of efficacy and effectiveness is not well studied. Our review demonstrated a need for more robust studies to yield strong evidence on effectiveness among stigma reduction interventions in this target population. The evidence does support tailoring intervention studies to this population. Effectively engaging and partnering with key stakeholders, including schools, community organizations, and faith-based institutions enhances the acceptance and delivery of stigma reduction interventions.

在非裔美国人中,精神疾病的长期性和严重性与较差的健康结果相关,并扩大了健康差距。与精神疾病相关的污名化会对求助行为造成障碍,从而加剧心理健康差距。我们研究了当前旨在减少非裔美国人对精神疾病的成见并促进改善其精神健康状况的工具。作者回顾了目前文献中有关此类减少污名化干预措施的证据。综述小组在四个数据库中进行了重点检索:PubMed、Embase、Scopus 和 APA PsycINFO。初步检索发现了 120 篇文章,其中有六项研究报告了在非裔美国人中减少精神疾病耻辱感的干预措施。我们将介绍这四项定量研究和两项定性研究。在非裔美国人中已经使用了多种干预措施来减少精神疾病耻辱感,但对其效力和有效性的研究并不充分。我们的综述表明,需要进行更多强有力的研究,以有力地证明减少对这一目标人群的污名化干预措施的有效性。证据确实支持针对这一人群开展干预研究。与包括学校、社区组织和宗教机构在内的主要利益相关者进行有效的接触和合作,可以提高减少耻辱化干预措施的接受度和实施效果。
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引用次数: 0
Parents' Perceived Neighborhood Safety and Children's Internalizing Symptoms: Race and Socioeconomic Status Differences. 父母感知邻里安全与儿童内化症状:种族和社会经济地位差异。
Pub Date : 2021-01-01 Epub Date: 2021-03-19
Shervin Assari

Background: In the United States, due to residential segregation, racial minorities and families with low socioeconomic status (SES) tend to live in less safe neighborhoods than their White and high SES counterparts. As such, in the US, race and SES closely correlate with neighborhood safety. Due to the high chronicity of stress in unsafe neighborhoods, perceived neighborhood safety may be a mechanism through which race and SES are linked to children's mental health. Simultaneously, race and SES may alter the effects of perceived neighborhood safety on children's mental health.

Aim: To explore racial and SES differences in the effects of neighborhood safety on children's internalizing symptoms, we compared racially and SES diverse groups of American children for the effects of parents' perceived neighborhood safety on children's internalizing symptoms.

Methods: This cross-sectional study included 10484 children from the Adolescent Brain Cognitive Development (ABCD) study. Mixed-effects regression was used for data analysis. The predictor variable was parents' perceived neighborhood safety which was treated as a continuous measure. The primary outcome was children's internalizing symptoms reported by children. Race, parental education, household income, and family structure were moderators.

Results: Overall, the parents' high neighborhood safety was associated with lower levels of internalizing symptoms in children. Race and household income showed statistically significant interactions with subjective neighborhood safety on children's internalizing symptoms. Parents' perceived neighborhood safety showed a stronger inverse association with children's internalizing symptoms for Black than White families. Parents' perceived neighborhood safety showed a stronger inverse association with children's internalizing symptoms for high income than low-income families. Parental education or family structure did not show any significant interaction with parents' perceived neighborhood safety on children's internalizing symptoms.

Conclusion: The degree to which neighborhood safety may be associated with children's internalizing symptoms may depend on race and household income. Some of the effects of race and SES on children's mental health outcomes may be due to interactions with contextual factors such as neighborhood safety. More research is needed on why and how diverse racial and SES groups differ in the association between perceived neighborhood safety and children's well-being.

背景:在美国,由于居住隔离,少数族裔和社会经济地位低的家庭往往比白人和高社会经济地位的家庭生活在更不安全的社区。因此,在美国,种族和社会经济地位与社区安全密切相关。由于在不安全的社区中压力的高长期性,感知到的社区安全可能是种族和社会经济地位与儿童心理健康相关的一种机制。同时,种族和社会经济地位可能改变邻里安全感知对儿童心理健康的影响。目的:探讨社区安全对儿童内化症状影响的种族和社会经济地位差异,比较不同种族和社会经济地位的美国儿童父母感知社区安全对儿童内化症状的影响。方法:本横断面研究包括来自青少年大脑认知发展(ABCD)研究的10484名儿童。采用混合效应回归进行数据分析。预测变量为家长对邻里安全的感知,并将其作为一项连续测量。主要结局是儿童报告的内化症状。种族、父母教育程度、家庭收入和家庭结构是调节因素。结果:总体而言,父母的高邻里安全与儿童较低的内化症状水平相关。种族和家庭收入对儿童内化症状的主观邻里安全有显著的交互作用。与白人家庭相比,黑人家庭的父母对社区安全的感知与儿童的内化症状呈更强的负相关。高收入家庭的父母对社区安全的感知与儿童内化症状的负相关强于低收入家庭。父母教育或家庭结构与父母感知的邻里安全对儿童内化症状没有显著的相互作用。结论:社区安全对儿童内化症状的影响程度可能与种族和家庭收入有关。种族和社会经济地位对儿童心理健康结果的一些影响可能是由于与环境因素(如邻里安全)的相互作用。不同种族和社会经济地位群体在感知社区安全和儿童福祉之间的关系上为何以及如何存在差异,还需要更多的研究。
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引用次数: 0
Commentary: Thirteen Reasons Why: The Impact of Suicide Portrayal on Adolescents’ Mental Health 评论:《十三个原因:自杀形象对青少年心理健康的影响》
Pub Date : 2020-06-01 DOI: 10.29245/2578-2959/2020/2.1193
M. Grant, Hala El-Agha, T. Ho, S. Johnson
Thirteen Reasons Why (13RY) is a Netflix series that tells the story of a high school girl named Hannah Baker, who died from suicide due to a series of painful events of betrayal, sexual assault, bullying from classmates, and lack of support from friends, family, and school staff. She prepared and left behind a box with a suicide note and 13 audiotapes to give insight into her suicide. In Thirteen Reasons Why: The impact of suicide portrayal on adolescents’ mental health, Rosa et al. investigated “the influence of media portrayals of suicide on adolescent’s mood” by providing a descriptive, qualitative perspective of mental health, suicidality, and the prevalence of suicidal behavior or ideation, along with emotional processes most affected by the sensationalism and normalization of suicide. This commentary discusses the impact of suicide portrayal on adolescents and highlights the backlash that occurred in response to how 13RY depicted suicide by expanding on the study’s limitations, highlighting controversial issues, and making recommendations for future research by revealing the omission of certain key facts.
《十三个原因》(13 Reasons Why, 13RY)是Netflix的一部电视剧,讲述了一个名叫汉娜·贝克(Hannah Baker)的高中女生因遭受背叛、性侵犯、同学欺凌、缺乏朋友、家人和学校工作人员的支持等一系列痛苦事件而自杀的故事。她准备并留下了一个装有遗书的盒子和13盘录音带,以了解她的自杀情况。在《十三个原因:自杀描述对青少年心理健康的影响》一书中,Rosa等人通过对心理健康、自杀倾向、自杀行为或自杀意念的流行以及受自杀耸人听闻和正常化影响最大的情绪过程提供描述性、定性的视角,调查了“媒体对自杀描述对青少年情绪的影响”。这篇评论讨论了自杀描述对青少年的影响,并强调了对13RY如何描述自杀的反应,通过扩展研究的局限性,突出有争议的问题,并通过揭示某些关键事实的遗漏为未来的研究提出建议。
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引用次数: 1
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