SSM. Mental health最新文献

{"title":"Hero-based interventions to promote health and education in young people: A scoping review","authors":"Kevin O'Malley ,&nbsp;Elaine L. Kinsella ,&nbsp;Eric R. Igou ,&nbsp;Alison English ,&nbsp;Jennifer McMahon","doi":"10.1016/j.ssmmh.2025.100439","DOIUrl":"10.1016/j.ssmmh.2025.100439","url":null,"abstract":"<div><h3>Objective</h3><div>Programs using heroes to promote positive health and educational outcomes for children and adolescents have been increasingly implemented. However, a comprehensive review of such interventions is lacking. This scoping review maps the existing empirical literature on hero-based interventions.</div></div><div><h3>Method</h3><div>A systematic search of databases including CINAHL, ERIC, MEDLINE, and others (final search February 2025), covering all years up to January 2025 identified peer-reviewed studies in English on hero-based interventions targeting health or educational outcomes in children and adolescents. Exclusions in-cluded non-English papers, those lacking empirical results, focusing on adults, or classified as grey literature. Data on study characteristics were extracted and analyzed using Arksey and O'Malley's (2005) framework.</div></div><div><h3>Results</h3><div>From 134 screened articles, 39 met the inclusion criteria, identifying 11 distinct programs targeting diverse populations across regions such as the U.S., U.K., India, Turkey, and Japan. These programs, im-plemented in both educational and clinical settings, addressed physical and mental health, education, social skills, and trauma recovery. The review assessed empirical support for these programs, noting variability in evidence strength, and highlighted their adaptability across different cultural contexts.</div></div><div><h3>Conclusions</h3><div>Hero-based interventions show promise in supporting youth across various outcomes, though no universal approach exists. Tailoring interventions to the specific cultural and contextual needs of young people is essential. Future research should focus on refining these methods, matching heroes to participants, and independent replication.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100439"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PsyBot: A randomized controlled trial of WhatsApp-based psychological first aid to reduce loneliness among 18–22-year-old students in Yogyakarta, Indonesia","authors":"Indrayanti Indrayanti ,&nbsp;Annisa Khomsah Salsabila ,&nbsp;Virna Amrita ,&nbsp;Muhammad Muqtada Alhaddad ,&nbsp;Anggita Bella Saskia ,&nbsp;Dhaifina Putri Ramadhani","doi":"10.1016/j.ssmmh.2025.100504","DOIUrl":"10.1016/j.ssmmh.2025.100504","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness among university students in Yogyakarta, Indonesia, is a growing mental health concern linked to psychological distress and suicidal ideation. Psychological First Aid (PFA) is a recognized approach for mitigating distress, yet access to human-led interventions remains limited. AI-powered chatbots offer a scalable alternative, but their effectiveness in loneliness reduction is underexplored.</div></div><div><h3>Objective</h3><div>This study evaluates the effectiveness of an AI-driven WhatsApp chatbot in delivering PFA and reducing student loneliness.</div></div><div><h3>Methods</h3><div>A mixed-methods randomized controlled trial was conducted among 32 university students in Yogyakarta (aged 18–22) with UCLA Loneliness Scale scores ≥35. Participants were randomly assigned to an experimental group (n = 16, PsyBot interaction) or control group (n = 16, neutral activity). The intervention involved a 30-min text-based PFA session via PsyBot. Pre- and post-intervention loneliness scores were analysed using paired and independent t-tests. Thematic analysis examined chatbot-user interactions.</div></div><div><h3>Results</h3><div>The experimental group showed a significant reduction in loneliness (M = 53.1 to M = 47.3; t (15) = 3.12, p = 0.007); no change was observed in the control group. Thematic analysis confirmed PsyBot's adherence to PFA principles by detecting distress (Look), providing empathetic responses (Listen), and offering coping suggestions (Link).</div></div><div><h3>Conclusion</h3><div>AI-powered PFA shows promise in addressing student loneliness and increasing mental health accessibility. Future studies should evaluate long-term effects, cultural adaptability, and integration into institutional services.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100504"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse migration experiences, border community stress, and the mental health of asylum-seeking women in transit at the Mexico-U.S. border","authors":"Shira M. Goldenberg ,&nbsp;Kayla Saadeh ,&nbsp;Kaylee Ramage ,&nbsp;Eileen Pitpitan ,&nbsp;Steffanie Strathdee ,&nbsp;Monica Álvarez Aguilar ,&nbsp;Nicole Elizabeth Ramos ,&nbsp;Gudelia Rangel ,&nbsp;Ietza Bojorquez","doi":"10.1016/j.ssmmh.2025.100567","DOIUrl":"10.1016/j.ssmmh.2025.100567","url":null,"abstract":"<div><div>We evaluated the association between adverse migration experiences, border community stress, and mental health symptoms in a community-recruited sample of asylum-seeking women. As part of a mixed-methods, community-academic partnership, we analyzed cross-sectional questionnaires conducted with asylum-seeking women at the Tijuana-San Diego border (N = 151) between Feb–July 2024. Symptoms of anxiety (56.6 %), moderate-to-severe depression (45.9 %), and post-traumatic stress (52 %) were common, with 70.1 % experiencing symptoms of at least one of these. Most (82.1 %) faced adverse experiences during migration journey and high levels of current border community stress. When we examined the relationship between each type of adverse migration experience and mental health symptoms, lack of safe shelter during migration was marginally associated with experiencing current generalized anxiety symptoms, whereas other types of adverse experiences had positive, but null, associations. Higher border community stress was associated with experiencing generalized anxiety, depression, and PTSD symptoms. Asylum-seeking women at the Mexico-U.S. border face significant mental health risks during migration and while waiting to enter the U.S. Structural and multilevel interventions to mitigate these are needed, including changes to asylum deterrence policies and scale-up of humanitarian services.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100567"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime prevalence of mental disorders and the costs for civic engagement among college and university students: Insights from the Norwegian SHoT2022 cohort","authors":"Lisa-Christine Girard ,&nbsp;Martin Okolikj ,&nbsp;Mari Hysing ,&nbsp;Børge Sivertsen","doi":"10.1016/j.ssmmh.2025.100519","DOIUrl":"10.1016/j.ssmmh.2025.100519","url":null,"abstract":"<div><div>The high prevalence of mental disorders has become a globally pervasive social issue resulting in its placement as among one of the leading causes of the global burden of disease. Noteworthy, prevalence estimates of college and university students affected by mental disorders are, in particular, exceedingly high. This may have important consequences for early habit formation of civic engagement given the developmental period (e.g., first time eligible voters). Using data from the Students’ Health and Wellbeing study (SHoT2022) – a nationally representative survey of college/university students across Norway – we examine how lifetime prevalence of common mental disorders (i.e., major depressive episode, generalized anxiety disorder, and social anxiety disorder) impact upon politically-oriented (i.e., voting) and community-oriented participatory activities (e.g., sports, cultural clubs, student-democracy, special interest groups, professional associations or off campus volunteering). Our findings suggest nuanced associations, whereby students with a lifetime prevalence <em>of social anxiety disorder</em> are less likely to turnout to vote (average marginal effects [AMEs] are 2.5 percentage points lower for both the national and municipal level elections). Meanwhile, students with either <em>generalized anxiety disorder</em> or <em>social anxiety disorder</em> are at risk of reduced participation in community-oriented activities (AMEs range from −1.5 to −2.3 percentage point across activities), and students with major depressive episode evidence both positive (participation in special interest groups equal to 2 percentage points) and negative (participation in sports equal to −1.5 percentage points) associations. Our results highlight the impact that lifetime prevalence of mental disorders, in particular anxiety disorders, may have on reducing mobilization into civic engagement (i.e., political- and community-oriented participatory activities) in college/university students.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100519"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the individual: Household activity of daily living limitations, urban-rural residence, and mental health","authors":"Kaitlin Shartle ,&nbsp;Jennifer E. Lansford ,&nbsp;Marcos Vera-Hernández ,&nbsp;Arnab Mukherji ,&nbsp;Manoj Mohanan ,&nbsp;Joanna Maselko","doi":"10.1016/j.ssmmh.2025.100547","DOIUrl":"10.1016/j.ssmmh.2025.100547","url":null,"abstract":"<div><div>Activity of daily living (ADL) limitations, such as difficulty walking or dressing, are increasing as populations age and experience more chronic conditions. To understand the scope of ADLs and make interventions more effective, it is important to examine ADLs beyond the individual to other levels and contexts, such as the household. Thus, using household and individual level survey data in India, we assess how household ADLs relate to the mental health of others in the household. We find that around 40 % of households have at least one resident with an ADL limitation, with ADL limitations more likely in households that are in rural areas, have older residents, and are socioeconomically disadvantaged. Household ADL limitations are associated with increased symptoms of depression and anxiety with the relation varying by the number of household members with an ADL limitation. For adults, having any household member with an ADL limitation is associated with increased mental health symptomology, whereas for young adults, this association only appears for those with multiple household members with an ADL limitation. Further, we find that the relation between household ADL limitations and mental health is stronger for those living in rural areas compared to urban areas. That is, when comparing individuals with the same number of household members with ADL limitations, predicted mental health symptomology is higher for those living in rural areas than for those in urban areas. These findings suggest the need for household centered accommodations and supports that consider the social and environmental context.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100547"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Taiwanese patient-caregiver concordance on death preparedness with dyadic end-of-life outcomes","authors":"Fur-Hsing Wen ,&nbsp;Chia-Hsun Hsieh ,&nbsp;Wen-Chi Chou ,&nbsp;Jen-Shi Chen ,&nbsp;Wen-Cheng Chang ,&nbsp;Siew Tzuh Tang","doi":"10.1016/j.ssmmh.2025.100553","DOIUrl":"10.1016/j.ssmmh.2025.100553","url":null,"abstract":"<div><h3>Background</h3><div>Despite dyadic interdependence of preparedness for death, associations of death preparedness (conjoint cognitive prognostic awareness and emotional acceptance) with psychological distress and quality of life (QOL) have been mainly examined cross-sectionally in patients or caregivers. This study longitudinally assessed associations of patient-caregiver concordance on death preparedness with dyads' psychological distress, QOL, and caregivers’ burden.</div></div><div><h3>Patients/methods</h3><div>Among 520 Taiwanese terminal cancer dyads, multivariate hierarchical linear models examined associations between death-preparedness concordance and anxiety, depression, QOL, and caregiving burden, separately for patients and caregivers across four concordant states (unprepared-concordant, cognitive-concordant, emotional-concordant, and sufficient-concordant) versus discordance, reported as β estimates with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>Death-preparedness concordance was associated with outcomes, except unprepared concordance showed no association with patient outcomes, and emotional concordance was unrelated to caregiver outcomes. Relative to the discordant group, patients in the cognitive-concordant state had more anxiety (0.927 [0.364, 1.490]) and worse QOL (−3.933 [-6.661, −1.205]), whereas those in the emotional-concordant state had fewer symptoms of anxiety (−1.913 [-3.154, −0.672]) and depression (−1.617 [-3.128, −0.106]). The sufficient-concordant state was associated with fewer anxiety symptoms (−0.940 [-1.471, −0.409]) and better QOL (4.119 [1.252, 6.986]). Caregivers in unprepared- and cognitive-concordant states had more depressive symptoms and worse QOL, while those in the sufficient-concordant state reported fewer depressive symptoms (−1.960 [-3.348, −0.572]) and better QOL (3.922 [1.419, 6.425]). Cognitive-concordant caregivers also reported higher subjective burden (2.228 [0.962, 3.494]).</div></div><div><h3>Conclusions</h3><div>Sufficient concordance in death preparedness reduces patient anxiety and caregiver depression while improving dyads’ QOL, underscoring its role in enhancing end-of-life outcomes.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100553"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive interviewing for understanding and adaptation of mental health screening instruments among people living with HIV in rakai, Uganda: the thinking a lot questionnaire, the patient health questionnaire 9 (PHQ-9), and the hopkins symptoms checklist (HSCL)","authors":"Nora S. West ,&nbsp;Lydia P. Namuganga ,&nbsp;Dauda Isabirye ,&nbsp;Rosette Nakubulwa ,&nbsp;William Ddaaki ,&nbsp;Neema Nakyanjo ,&nbsp;Fred Nalugoda ,&nbsp;Sarah M. Murray ,&nbsp;Caitlin E. Kennedy","doi":"10.1016/j.ssmmh.2025.100517","DOIUrl":"10.1016/j.ssmmh.2025.100517","url":null,"abstract":"<div><h3>Background</h3><div>Mental health is conceptualized differently across cultures, making exploration of the understandability of screening tools for the purpose of adaptation critical.</div></div><div><h3>Methods</h3><div>In Uganda, we used cognitive interviewing to understand comprehension of and make adaptations to three scales for measuring psychological distress: the Thinking Too Much (TTM) Questionnaire, the Patient Health Questionnaire 9 (PHQ-9), and the Hopkins Symptoms Checklist (HSCL). We recruited 12 people living with HIV from the Rakai Community Cohort Study (RCCS) and interviewed seven potential users of the scales (four RCCS survey interviewers and three local health workers). Data were analyzed systematically using a team-based matrix approach.</div></div><div><h3>Results</h3><div>The HSCL was generally well understood, with minor clarifications needed. The TTM Questionnaire was also well understood, though differences between “how much” and “how often” required specificity. Both included local idioms of distress from prior adaptations. The PHQ-9 performed less well, with many questions interpreted variably or showing unclear local applicability, especially among people living with HIV. For example, questions about trouble concentrating were misunderstood, focusing on examples like newspapers rather than the broader issue of concentration.</div></div><div><h3>Conclusion</h3><div>Future research should explore the validity and utility of commonly used instruments as mental health research expands in Africa, and both researchers and public health programmers should consider the strengths and limitations of screening instruments in their setting.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100517"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually explicit and violent media use among high school students in Vietnam: Gender-differentiated links with sexual misconduct victimization, perpetration, and health","authors":"Kathryn M. Yount ,&nbsp;Meghan Macaulay ,&nbsp;Kim Tu Tran","doi":"10.1016/j.ssmmh.2025.100520","DOIUrl":"10.1016/j.ssmmh.2025.100520","url":null,"abstract":"<div><h3>Background</h3><div>In lower-income countries, research is lacking on levels and associations of using <em>sexually explicit, physically non-violent media</em> (SEM) or <em>sexually explicit, physically violent media</em> (SVM) with well-being outcomes in high-school students.</div></div><div><h3>Objective</h3><div>We tested theories of gendered aggression and moral incongruence to explain the associations of SEM use and/or SVM use versus non-use with sexual misconduct perpetration/victimization and other well-being outcomes among students attending three high schools in Ho Chi Minh City, Vietnam.</div></div><div><h3>Method</h3><div>712 students completed surveys about their general health, mental health, alcohol use, academic disengagement, sexual misconduct perpetration and victimization, beliefs about pro-violence peer norms, and any SEM/SVM use in the prior six months. Unadjusted and adjusted regression models were estimated.</div></div><div><h3>Results</h3><div>Most reported SEM (47 %) or SVM (32 %) use. SVM use was higher among boys (39 %) than girls (27 %) (χ² <em>p</em> = 0.01). Among boys, compared to non-users, users reported worse self-rated health (SEM acoef = 0.44 (0.10, 0.78); SVM acoef = 0.58 (0.23, 0.93)), higher alcohol use (SEM aOR = 2.42 (1.06, 5.58); SVM aOR = 2.44 (1.05, 5.62)), and higher sexual <em>misconduct</em> perpetration involving physical dating violence, stalking, or sexual violence (SVM aOR = 5.02 (1.39, 18.06)). Among girls, compared to non-users, SVM users reported higher sexual <em>misconduct</em> perpetration (aOR = 2.59 (1.13, 5.92)) and sexual violence victimization (aOR = 5.74 (1.81, 18.22)); SEM users reported higher sexual misconduct victimization involving physical dating violence, sexual harassment, stalking, or sexual violence (OR = 2.32 (1.33, 4.04)).</div></div><div><h3>Conclusion</h3><div>Most high-school students in this study reported sexualized media use, and boys reported SVM use more often than girls. Corroborating gendered aggression theory, sexualized media use tended to predict violence perpetration among boys and victimization among girls. Corroborating moral incongruence theory, boys’ use was associated with worse self-rated health and alcohol use. Contextualized programs may reduce student access to common modalities of sexualized media use and educate school communities about the harms of use.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100520"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to suicide research are also barriers to suicide prevention:Insights from conducting a mixed-methods project in oncology","authors":"Judith Hirschmiller ,&nbsp;Tamara Schwinn ,&nbsp;Jörg Wiltink ,&nbsp;Manfred E. Beutel ,&nbsp;Rüdiger Zwerenz ,&nbsp;Elmar Brähler ,&nbsp;Mareike Ernst","doi":"10.1016/j.ssmmh.2025.100484","DOIUrl":"10.1016/j.ssmmh.2025.100484","url":null,"abstract":"<div><div>Cancer patients are at risk for suicidal crises. There is a need for more research concerning specific risk/protective factors and knowledge about barriers and resources of prevention efforts in clinical practice. This contribution reports on difficulties during the realization of a research project that aimed to address these research gaps, among other approaches, via a patient survey and an interview study with healthcare professionals (HCPs). Throughout recruitment and implementation, we documented the barriers encountered and systematically analyzed them.</div><div>We identified three main categories of obstacles toward the research endeavor that also hold meaning for the efficacy of suicide prevention: First, <em>suicidal thoughts and behaviors are not (allowed to be) an issue in oncology</em>, subsuming the denial of their occurrence, the minimization of their relevance, the alleged appropriateness of the construct to oncology, and the rejection of responsibility; second, <em>prevailing suicide myths</em>, in particular of iatrogenic harm; and third, <em>strong, negative emotional reactions undermining dialogue</em>.</div><div>We interpret these experiences against previous considerations of dysregulated responses to suicidal patients in the healthcare setting and analyze their causes and functions. These findings highlight the urgent need for structured education on suicide prevention across medical disciplines, particularly in oncology. Addressing both knowledge gaps and emotional barriers among HCPs is crucial for fostering a proactive, evidence-based approach to suicide prevention. Future efforts should focus on integrating suicide risk assessment and intervention strategies into routine cancer care, alongside improved interdisciplinary collaboration and institutional support.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100484"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective social status in relation to the associations between internalized stigmas and missed HIV appointments among MSM who use substances","authors":"Abigail W. Batchelder ,&nbsp;Jacklyn D. Foley ,&nbsp;Claire Burgess ,&nbsp;Oscar Mairena ,&nbsp;Jinlin Liu ,&nbsp;Kenneth H. Mayer","doi":"10.1016/j.ssmmh.2025.100477","DOIUrl":"10.1016/j.ssmmh.2025.100477","url":null,"abstract":"<div><div>Men who have sex with men (MSM) living with HIV who use substances often report internalized stigma associated with aspects of their identities and behaviors, which can negatively influence health behaviors including engagement in HIV care. Given the de-valuing nature of stigma, one's perception of their hierarchical rank in society may account for the relationships between internalized stigma and suboptimal engagement in HIV care. This study investigated relationships between internalized stigmas (i.e., linked to HIV-status, sexual orientation, and substance use), subjective social status in relation to one's community and the U.S., and missed HIV appointments among 143 MSM living with HIV who use substances. In bivariate regression models, internalized HIV stigma related to disclosure (<em>OR</em> = 1.46; confidence interval [CI]: 1.02, 2.09), and substance use stigma (<em>OR</em> = 1.07; CI:1.02, 1.12) were associated with greater odds of missing HIV appointments. Self-perception of higher social status in one's community (<em>OR</em> = 0.81; CI: 0.69, 0.96) and the U.S. (<em>OR=</em> 0.80; CI: 0.69, 0.94) were associated with lower odds of missing HIV appointments. Indirect effects models demonstrated that subjective social status in the U.S., but not in one's community, explained variance in the relationship between internalized HIV and sexual orientation stigmas and missing HIV appointments. Results suggest that perceptions of social status in the U.S. may partially account for the associations between internalized HIV and sexual orientation-related stigmas and sub-optimal engagement in HIV care, potentially related to the discriminatory policies and practices across the U.S., in contrast to more liberal states such as where this study took place. Efforts, including policies, are needed to stop the devaluation of people with stigmatized identities nationally, including those living with HIV and those who identify as sexual minorities, to improve the health and well-being of all people.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100477"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}