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Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults 在一项针对成年人的跨国研究中,凯斯勒心理压力量表(K10)在四个非洲国家的跨文化等效性
Q1 PSYCHIATRY Pub Date : 2024-02-10 DOI: 10.1016/j.ssmmh.2024.100300
Amantia A. Ametaj , Christy A. Denckla , Anne Stevenson , Rocky E. Stroud II , Jasmine Hall , Linnet Ongeri , Barkot Milkias , Jacob Hoffman , Molly Naisanga , Dickens Akena , Joseph Kyebuzibwa , Edith K. Kwobah , Lukoye Atwoli , Stella Gichuru , Solomon Teferra , Melkam Alemayehu , Zukiswa Zingela , Dan J. Stein , Adele Pretorius , Charles R.J.C. Newton , Bizu Gelaye

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all.

Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items “so nervous,” “lack of energy/effortful tasks,” and “tired” were consistently equivalent for intercepts and factor loadings, respectively. However, items “depressed” and “so depressed” consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items.

The K10 scale likely functions equivalently across the four countries for most items, except “depressed” and “so depressed.” Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.

凯斯勒心理压力量表(K10)已被许多国家广泛用于筛查心理压力。然而,该量表在非洲的表现尚未得到广泛研究。本研究试图评估和比较 K10 在四个非洲国家的测量特性:埃塞俄比亚、肯尼亚、乌干达和南非。数据来自一项神经精神遗传学研究,研究对象是埃塞俄比亚(n = 1928)、肯尼亚(n = 2556)、乌干达(n = 2104)和南非(n = 2591)的普通医疗机构的成年参与者(n = 9179)。采用确证因子分析和排列优化法,对具有相关误差的单维模型进行了跨研究国家等效性测试。结果显示,所有国家的截距和因子载荷均存在 30% 的非方差(即变异)。蒙特卡罗模拟显示相关性为 0.998,很好地复制了群体值,表明非方差或变异极小。紧张"、"缺乏活力/任务繁重 "和 "疲倦 "这三个项目的截距和因子载荷分别一致。然而,"抑郁 "和 "非常抑郁 "这两个项目的截距和因子载荷在不同研究国家之间一直存在差异(R2 = 0)。除了 "抑郁 "和 "非常抑郁 "之外,K10 量表的大多数项目在四个国家之间的功能可能是等效的。在肯尼亚和埃塞俄比亚,K10 量表项目的差异更为常见,这表明文化背景可能会影响某些项目的解释,在这些国家可能需要进行文化调整。
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引用次数: 0
Sexual orientation-related disparities in perinatal mental health among a prospective cohort study 前瞻性队列研究中与性取向有关的围产期心理健康差异
Q1 PSYCHIATRY Pub Date : 2024-02-05 DOI: 10.1016/j.ssmmh.2024.100301
Kodiak R.S. Soled , Sarah McKetta , Payal Chakraborty , Colleen A. Reynolds , S. Bryn Austin , Jorge E. Chavarro , A. Heather Eliassen , Siwen Wang , Sebastien Haneuse , Brittany M. Charlton

Sexually minoritized women (SMW) may be at an increased risk of adverse perinatal mental health, though prior research is limited. We examined sexual orientation-related differences in perinatal mental health (i.e., stress and depression), and antidepressant utilization among those at different severities of clinically significant perinatal depressive symptoms.

Nurses’ Health Study 3 participants with prospectively assessed pregnancies (N = 6,364) received pregnancy and postpartum questionnaires. Using weighted log-binomial generalized estimating equations, we examined differences in stress (Perceived Stress Scale 4 [PSS-4]), depression (the Edinburgh Postnatal Depression Scale [EDPS] at four cut-off scores [≥7, ≥9, ≥11, ≥13]), and patterns of antidepressant utilization across five groups: completely heterosexual with no same-sex sexual partners (reference group; n = 5,178); heterosexual with same-sex sexual partners (n = 245); mostly heterosexual (n = 770); bisexual (n = 106); and lesbian (n = 47).

Compared to the completely heterosexual reference group, SMW reported increased stress during pregnancy (adjusted risk ratio [ARR]: 1.14, 95% confidence interval [1.02–1.28]). SMW reported an elevated risk of pregnancy depression at every EDPS score cutoff, with the magnitude of the disparity increasing as the score increased (ARRs: 1.09 [1.00–1.20]; 1.20 [1.05–1.36]; 1.37 [1.16–1.63]; 1.49 [1.18–1.89] for EDPS scores ≥7, ≥9, ≥11, ≥13, respectively). Disparities were highest in magnitude among the mostly heterosexual and bisexual subgroups. Utilization of postpartum antidepressants increased among the reference group with increasing symptom severity but was only associated at the highest score (≥13) among SMW subgroups.

SMW have increased risks of pregnancy stress and depression and are more likely to use perinatal antidepressants; mostly heterosexual and bisexual individuals had the highest risk of antidepressant use. Postpartum symptom severity closely corresponded to antidepressant use among completely heterosexual, but not SMW—suggesting disparities in mental health treatment. Further research priorities include determining the causes of these disparities and appropriately tailored solutions.

性取向未成年女性(SMW)围产期心理健康不良的风险可能会增加,但之前的研究还很有限。我们研究了与性取向相关的围产期心理健康(即压力和抑郁)差异,以及临床上围产期抑郁症状严重程度不同的人群使用抗抑郁药的情况。护士健康研究 3(Nurses' Health Study 3)的参与者对妊娠进行了前瞻性评估(N = 6364),并接受了妊娠和产后问卷调查。利用加权对数二项式广义估计方程,我们研究了五个组别在压力(感知压力量表 4 [PSS-4])、抑郁(爱丁堡产后抑郁量表 [EDPS],四个截断分数[≥7、≥9、≥11、≥13])和抗抑郁药使用模式方面的差异:没有同性性伴侣的完全异性恋者(参照组;n = 5,178 人);有同性性伴侣的异性恋者(n = 245 人);大部分为异性恋者(n = 770 人);双性恋者(n = 106 人);以及女同性恋者(n = 47 人)。与完全异性恋参照组相比,SMW 在怀孕期间的压力更大(调整风险比 [ARR]:1.14,95% 置信区间 [1.02-1.28])。在 EDPS 的每个分值临界点,SMW 妊娠抑郁的风险都较高,随着分值的增加,差异的程度也在增加(调整风险比 [ARR]:1.09 [1.00-1.28],95% 置信区间 [1.02-1.28]):EDPS 评分≥7、≥9、≥11、≥13 时,差异率分别为 1.09 [1.00-1.20];1.20 [1.05-1.36];1.37 [1.16-1.63];1.49 [1.18-1.89])。主要是异性恋和双性恋亚群的差异程度最大。在参照组中,随着症状严重程度的增加,产后抗抑郁药的使用率也随之增加,但在 SMW 亚组中,只有在最高分(≥13 分)时才会出现相关情况。SMW 感染妊娠应激和抑郁症的风险更高,更有可能使用围产期抗抑郁药;主要为异性恋和双性恋者使用抗抑郁药的风险最高。在完全异性恋者中,产后症状的严重程度与抗抑郁药的使用密切相关,但在双性恋者中则不然--这表明在心理健康治疗方面存在差异。进一步研究的重点包括确定造成这些差异的原因,以及适当定制解决方案。
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引用次数: 0
PTSD and complex PTSD manifestations in Sub-Saharan Africa: A systematic review of qualitative literature 撒哈拉以南非洲的创伤后应激障碍和复杂的创伤后应激障碍表现:定性文献的系统回顾
Q1 PSYCHIATRY Pub Date : 2024-01-28 DOI: 10.1016/j.ssmmh.2024.100298
Marion Bovey , Nadine Hosny , Felicia Dutray , Eva Heim

Complex post-traumatic stress disorder (CPTSD) was introduced in the ICD-11 as a new diagnosis and was framed in accordance with WHO guidelines of clinical utility and cross-cultural applicability. CPTSD diagnosis comprises PTSD symptoms in addition to specific symptoms related to the organization of the self (DSO). Cross-cultural validity of the DSO symptoms is still being debated as cultural norms significantly influence how individuals perceive themselves and manage their emotions and relationships. The aim of this systematic review was to understand how PTSD and DSO symptoms were experienced and expressed by individuals from Sub-Saharan Africa (SSA) by exploring qualitative literature. Searches were conducted on nine databases using search terms for countries, methods, symptoms, and trauma exposure. Fifty studies were included. Results confirmed the presence of the three DSO clusters. However, their manifestation differed significantly from the defined diagnostic criteria, highlighting the importance of considering cultural factors in the diagnostic process. Additionally, the review indicated that structural factors played significant roles in shaping the interpretation of trauma-related distress in this cultural context. Thus, we propose to create and implement a cultural module as an add on to the actual CPTSD assessment tools to account for cultural and structural variations in the SSA population and improve diagnosis accuracy. In this perspective, more emic research is needed to gain a deeper understanding of how trauma-related distress is perceived, experienced, and interpreted in SSA.

复杂创伤后应激障碍(CPTSD)作为一种新的诊断被引入 ICD-11 中,其框架符合世界卫生组织关于临床实用性和跨文化适用性的指导方针。CPTSD 诊断包括创伤后应激障碍症状以及与自我组织相关的特定症状(DSO)。DSO 症状的跨文化有效性仍存在争议,因为文化规范会极大地影响个人如何看待自己以及如何管理自己的情绪和人际关系。本系统性综述旨在通过探索定性文献,了解撒哈拉以南非洲地区(SSA)的个人如何体验和表达创伤后应激障碍和 DSO 症状。我们使用国家、方法、症状和创伤暴露等检索词在九个数据库中进行了检索。共纳入 50 项研究。结果证实了三个 DSO 群组的存在。但是,它们的表现形式与定义的诊断标准有很大不同,这突出了在诊断过程中考虑文化因素的重要性。此外,综述还表明,在这种文化背景下,结构性因素对创伤相关痛苦的解释起着重要作用。因此,我们建议创建并实施一个文化模块,作为 CPTSD 实际评估工具的附加模块,以考虑到 SSA 人口中的文化和结构差异,提高诊断的准确性。从这个角度来看,我们需要开展更多的情绪研究,以便更深入地了解在 SSA 中与创伤相关的痛苦是如何被感知、体验和解释的。
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引用次数: 0
Engaging Mozambican men in a couple-based therapy to reduce intimate partner violence and improve mental health: Community stakeholders’ perspectives 让莫桑比克男性参与以夫妻为基础的治疗,以减少亲密伴侣间的暴力行为并改善心理健康:社区利益相关者的观点
Q1 PSYCHIATRY Pub Date : 2024-01-20 DOI: 10.1016/j.ssmmh.2024.100297
Jennifer J. Mootz , Palmira Fortunato dos Santos , Katia dos Santos , Sandra Stith , Milton L. Wainberg , John Oliffe
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引用次数: 0
Real men don't talk? Relationships among depressiveness, loneliness, conformity to masculine norms, and male non-disclosure of mental distress 真正的男人不说话?抑郁、孤独、符合男性规范与男性不披露精神痛苦之间的关系
Q1 PSYCHIATRY Pub Date : 2024-01-06 DOI: 10.1016/j.ssmmh.2024.100296
Anna J.M. Wagner , Doreen Reifegerste

Men are a particularly challenging group when it comes to mental health communication. Non-disclosure of mental distress is quite common among men in general, and even more so among depressed men – despite its detrimental effects on health. Motivating men to share their mental distress with trusted social contacts serves as a vital first step in addressing and improving their mental health – both for those men who are affected by mental illness and those who are not. To overcome the barriers to communicating about mental distress, knowledge about the aspects associated with non-disclosure is indispensable. Bringing together assumptions from interpersonal communication and (mental) health communication literature, we propose a conceptual model of the relationships among depressiveness, loneliness, conformity to masculine norms, number of trusted social contacts, and non-disclosure of mental distress. To empirically test our model, we conducted a cross-sectional online survey with 1,400 men in Germany. Findings largely substantiate our model. They show that a higher depressiveness is positively associated with men's non-disclosure of mental distress – both directly and mediated through several other variables. Loneliness emerged as an important mediating factor, with a higher depressiveness being linked to higher loneliness, which increased the likelihood for men's non-disclosure. Depressiveness was also associated with a higher conformity to traditional masculine norms, again making non-disclosure of mental distress more probable.

在心理健康交流方面,男性是一个特别具有挑战性的群体。在一般男性中,不披露精神痛苦的情况相当普遍,在抑郁男性中更是如此--尽管这会对健康产生不利影响。无论是对受精神疾病影响的男性还是未受精神疾病影响的男性而言,激励男性与可信赖的社会联系人分享他们的精神痛苦是解决和改善其心理健康的重要第一步。要克服交流精神痛苦的障碍,了解与不披露相关的方面是必不可少的。结合人际沟通和(心理)健康沟通文献中的假设,我们提出了一个关于抑郁、孤独、对男性规范的遵从、可信任的社会联系人数量和不披露精神痛苦之间关系的概念模型。为了对我们的模型进行实证检验,我们对德国的 1400 名男性进行了横截面在线调查。调查结果在很大程度上证实了我们的模型。调查结果显示,男性抑郁程度越高,其不披露精神痛苦的程度越高--这既与抑郁程度直接相关,也与其他几个变量的中介作用相关。孤独感是一个重要的中介因素,较高的抑郁度与较高的孤独感有关,而孤独感增加了男性不披露的可能性。抑郁也与更多人遵守传统的男性规范有关,这也使得不披露精神痛苦的可能性更大。
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引用次数: 0
Child mental health and educational attainment: Longitudinal evidence from the UK 儿童心理健康与教育成就:英国的纵向证据
Q1 PSYCHIATRY Pub Date : 2023-12-28 DOI: 10.1016/j.ssmmh.2023.100294
Matthew van Poortvliet

There has been a recent spike in children's mental health problems and lost learning due to the Covid-19 pandemic. This study assesses the relationship between social, emotional and behavioural problems and academic attainment across the whole of mainstream schooling (ages 5–16). It uses a rich longitudinal dataset from the UK linked to national data on school records (N = 7,219), individual fixed effects, and repeated measures of mental health and attainment. It finds that within-individual changes in mental health across childhood predict changes in attainment, with hyperactivity and inattention the behaviours most strongly linked to adverse attainment outcomes. These difficulties are disproportionately seen in summer-born boys and those from disadvantaged backgrounds. The negative relationship with attainment strengthens as children progress through school, and affects children with problems mild enough that they would never be diagnosed. Schools and health services can gain important insights about a child's educational trajectory based on brief behavioural information obtained from parents.

最近,由于 Covid-19 大流行,儿童的心理健康问题和学习损失激增。本研究评估了整个主流学校教育阶段(5-16 岁)中社会、情感和行为问题与学业成绩之间的关系。研究使用了英国丰富的纵向数据集,该数据集与全国学籍数据(N = 7,219)、个人固定效应以及心理健康和学业成绩的重复测量数据相连接。研究发现,童年时期心理健康的个体内部变化可预测学业成绩的变化,多动和注意力不集中是与不良学业成绩最密切相关的行为。这些问题在夏季出生的男孩和来自贫困家庭的男孩中表现得尤为突出。这种与学业成绩的负面关系随着儿童的学业进展而加强,并影响到问题轻微到永远不会被诊断出来的儿童。学校和医疗服务机构可以根据从家长那里获得的简短行为信息,对儿童的教育轨迹有重要的了解。
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引用次数: 0
The imperative of lived experience for ME/CFS and long COVID research: What to make of patient stories 生活经验对 ME/CFS 和长期 COVID 研究的必要性:如何看待患者故事
Q1 PSYCHIATRY Pub Date : 2023-12-27 DOI: 10.1016/j.ssmmh.2023.100291
V. Jo Hsu
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引用次数: 0
Responding to structural inequities: Coping strategies among immigrant women during COVID-19 应对结构性不平等:COVID-19 期间移民妇女的应对策略
Q1 PSYCHIATRY Pub Date : 2023-12-24 DOI: 10.1016/j.ssmmh.2023.100293
Tara F. Abularrage , Heather M. Wurtz , Goleen Samari

Examining coping strategies and resilience among immigrant communities reflects a commitment to working with immigrant communities to understand their needs while also identifying and building upon their strengths. In the United States, the physical, emotional, and economic impacts of the COVID-19 pandemic intersected with existing structural inequities to produce distinct challenges and stressors related to the pandemic, immigration, caregiving responsibilities, and structural xenophobia. Leveraging an understanding of the multilevel effects of stress, this qualitative study explores individual, interpersonal, and community-level coping strategies immigrant women used to respond to, alleviate, or reduce distress related to these compounding stressors. Using semi-structured in-depth interviews conducted in 2020 and 2021 with 44 first- and second-generation cisgender immigrant women from different national origins and 19 direct service providers serving immigrant communities in New York City, data were coded and analyzed using a constant comparative approach. Four central themes were identified: caregiving as a source of strength, leveraging resources, social connections, and community support. While women described a range of coping strategies they used to manage stressors and challenges, perspectives from direct service providers also connect these coping strategies to the harm-generating institutions, policies, and structures that produce and uphold structural oppression and inequities. Accounts from service providers point to the detrimental long-term effects of prolonged coping, underscoring a duality between resilience and vulnerability. Exploring the coping strategies cisgender immigrant women used to ease distress and promote resilience during a period of heightened structural vulnerability is critical to centering the experiences of immigrant women while simultaneously directing attention towards addressing the fundamental causes of cumulative disadvantage and the systems and structures through which it is transmitted.

对移民社区的应对策略和复原力进行研究,体现了与移民社区合作以了解他们的需求,同时发现并利用他们的优势的决心。在美国,COVID-19 大流行病对身体、情感和经济的影响与现有的结构性不平等交织在一起,产生了与大流行病、移民、护理责任和结构性仇外心理相关的独特挑战和压力。本定性研究利用对压力的多层次影响的理解,探讨了移民妇女为应对、减轻或减少与这些复合压力相关的困扰而采取的个人、人际和社区层面的应对策略。通过在 2020 年和 2021 年对 44 名来自不同国家的第一代和第二代顺性别移民妇女以及 19 名为纽约市移民社区提供服务的直接服务提供者进行半结构式深度访谈,采用恒定比较法对数据进行编码和分析。确定了四个中心主题:作为力量源泉的照顾、利用资源、社会联系和社区支持。虽然妇女们描述了她们用来应对压力和挑战的一系列应对策略,但直接服务提供者的观点也将这些应对策略与造成伤害的机构、政策和结构联系起来,这些机构、政策和结构产生并维护着结构性压迫和不平等。服务提供者的叙述指出了长期应对的有害长期影响,强调了复原力和脆弱性之间的双重性。在结构脆弱性加剧的时期,探索顺性别移民妇女用来缓解痛苦和提高复原力的应对策略,对于以移民妇女的经历为中心,同时引导人们关注解决累积性不利处境的根本原因,以及传播这种不利处境的制度和结构至关重要。
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引用次数: 0
Frequency and perceived difficulty of household water experiences in Morogoro, Tanzania: Evidence of the psychosocial burden of water insecurity 坦桑尼亚莫罗戈罗家庭用水体验的频率和感受到的困难:用水不安全造成的社会心理负担的证据
Q1 PSYCHIATRY Pub Date : 2023-12-23 DOI: 10.1016/j.ssmmh.2023.100295
Cassandra L. Workman , Joshua D. Miller , Sameer H. Shah , Kenneth Maes , Yihenew Tesfaye , Kenneth M. Mapunda
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引用次数: 0
Racial discrimination and mental health in the context of anti-Asian xenophobia: An intersecting approach of race, ethnicity, nativity, and socioeconomic status 反亚裔仇外心理背景下的种族歧视与心理健康:种族、民族、原籍地和社会经济地位的交叉方法
Q1 PSYCHIATRY Pub Date : 2023-12-19 DOI: 10.1016/j.ssmmh.2023.100292
Yen-Tyng Chen , Yuqing Zhou , Sharifa Williams , Joel Cantor , Bruce G. Taylor , Phoebe A. Lamuda , Harold A. Pollack , John Schneider

The COVID-19 pandemic, polarized politics, and heightened stigma and discrimination are salient drivers for negative mental health outcomes, particularly among marginalized racial and ethnic minoritized groups. Intersectionality of race, ethnicity, foreign-born status, and educational attainment may distinctively shape an individual's experience of discrimination and mental health during such unprecedented time. The present study examines the differential associations of racial discrimination and mental health based on an individual's race, ethnicity, foreign-born status, and educational attainment during the COVID-19 pandemic. Analyses were based on a nationally representative sample of U.S. adults collected between October and November 2021 (n = 6276). We utilized multivariable linear regressions to identify the multiplicative effects of race, ethnic, foreign-born status and self-reported racial discrimination on mental health, stratified by educational attainment. Among individuals with lower educational attainment, associations between racial discrimination and poor mental health were stronger among Asians (US-born: β = −2.07, p = 0.03; foreign-born: β = −3.18, p = 0.02) and US-born multiracial individuals (β = −1.96, p = 0.02) than their White counterparts. Among individuals with higher educational attainment, foreign-born Hispanics (β = − 3.66, p < 0.001) and US-born Asians (β = −2.07, p = 0.01) reported worst mental health when exposed to racial discrimination out of all other racial, ethnic and foreign-born groups. Our results suggest that association of racial discrimination and mental health varies across racial, ethnic, foreign-born, and education subgroups. Using an intersectional approach to address the widening inequities in racial discrimination and mental health during the COVID-19 pandemic contextualizes unique experience of discrimination and provides crucial insight on the patterns of mental health among marginalized groups.

COVID-19 的流行、两极分化的政治以及污名化和歧视的加剧是导致消极心理健康结果的显著因素,尤其是在边缘化的种族和少数民族群体中。在这种前所未有的时期,种族、民族、外国出生身份和教育程度的交叉性可能会对个人的歧视经历和心理健康产生独特的影响。本研究探讨了在 COVID-19 大流行期间,基于个人的种族、民族、外国出生身份和教育程度,种族歧视与心理健康之间的不同关联。分析基于 2021 年 10 月至 11 月期间收集的具有全国代表性的美国成年人样本(n = 6276)。我们利用多元线性回归确定了种族、民族、外国出生身份和自我报告的种族歧视对心理健康的乘法效应,并按教育程度进行了分层。在教育程度较低的人群中,亚裔(美国出生:β = -2.07,p = 0.03;外国出生:β = -3.18,p = 0.02)和美国出生的多种族人群(β = -1.96,p = 0.02)的种族歧视与心理健康状况不佳之间的关联要强于白人。在受教育程度较高的人群中,外国出生的西班牙裔(β = - 3.66,p < 0.001)和美国出生的亚裔(β = -2.07,p = 0.01)在遭受种族歧视时的心理健康状况比其他种族、民族和外国出生的人群差。我们的研究结果表明,种族歧视与心理健康的关系因种族、民族、外国出生和教育程度的不同而异。在 COVID-19 大流行期间,采用交叉的方法来解决种族歧视和心理健康方面日益扩大的不平等问题,将独特的歧视经历背景化,并为边缘化群体的心理健康模式提供了重要的启示。
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引用次数: 0
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SSM. Mental health
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