PLOS mental health最新文献

{"title":"The association between depressive symptoms and antibody response following SARS-CoV-2 vaccination among central North Carolina residents.","authors":"Caitlin A Cassidy, Jessie K Edwards, Annika K Gunderson, Haley Abernathy, Haley E Garrett, Elise King, Cherese N Beatty Parker, Anne P Starling, Emily J Ciccone, Ross M Boyce, Bonnie E Shook-Sa, Allison E Aiello","doi":"10.1371/journal.pmen.0000410","DOIUrl":"10.1371/journal.pmen.0000410","url":null,"abstract":"<p><p>A large body of research suggests that stress can affect how the immune system responds to vaccines. The impact of mental health disorders on humoral antibody response following immunization is not well understood, particularly for the COVID-19 vaccines. Leveraging a population-based longitudinal cohort assessing SARS-CoV-2 incidence in central North Carolina, we sought to investigate the relationship between mental health and immune response to vaccination. The 106 participants responded to biweekly surveys and contributed monthly serum samples that underwent SARS-CoV-2 spike antibody testing via enzyme-linked immunosorbent assay (ELISA). Utilizing weighted generalized linear models, we measured the association between depressive symptoms as recorded on the CESD-20 and quantitative antibody levels after COVID-19. Overall, we found modest differences in post-vaccination IgG between participants with depression and those without. Individuals with depressive symptoms had smaller initial antibody responses after vaccination (mean difference = -3.55, 95% CI = (-12.01, 4.90)). These results suggest that mental health disorders may affect immune response to vaccination.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of insurance type on outpatient mental health treatment of US adults.","authors":"Lydia A Chwastiak, Scott Graupensperger, Heather Ringeisen, Mark Edlund, Heidi Guyer, Natalie Bareis, Maria Monroe-Devita, Lisa Dixon, Scott Stroup, Jeffrey Swanson, Marvin Swartz, Elizabeth Sinclair Hancq, Robert Gibbons, Ronald C Kessler, Mark Olfson","doi":"10.1371/journal.pmen.0000299","DOIUrl":"10.1371/journal.pmen.0000299","url":null,"abstract":"<p><p>The mental health treatment gap in the US continues to be a major public health challenge. Even individuals with health insurance face substantial barriers to care, including high costs, insufficient coverage and inaccurate provider directories. Policies to address the treatment gap require updated population-based information about whether treatment rates vary by type of insurance. The current study aimed to compare past-year outpatient mental health treatment across insurance types (private, Medicare, Medicaid, other, or none), in the household sample of non-elderly adults in the Mental and Substance Use Disorder Prevalence Study (MDPS), (n = 4,640). MDPS, fielded October 2020 through October 2022, identified 12-month prevalence of mental disorders and rates of treatment among US adults from interviews by trained clinicians using the Structured Clinical Interview for DSM-5. Logistic regressions estimated odds of treatment among participants with a past-year MDPS diagnosis across insurance types, after adjusting for age, sex, race/ethnicity, income level, diagnosis, and functional impairment. Analyses were weighted to reflect the US adult population. 60.2% of the 1,833 participants with an MDPS mental disorder received outpatient treatment in the past year. Compared to participants with private insurance, those with no insurance had lower odds of outpatient treatment (AOR = 0.37 [0.16-0.87]). Participants with Medicare had higher odds of treatment (AOR = 4.25 [1.56-11.64]), suggesting that individuals with complex and disabling illness were least likely to have treatment disruptions during the early phases of the pandemic. Differences between groups decreased as the pandemic progressed, but utilization of services only significantly increased among individuals with private insurance. Persisting mental health treatment gaps in the US vary by type of health insurance, which warrants extensive policy reforms.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental disorders and criminal legal involvement: Evidence from a national diagnostic epidemiological survey.","authors":"Jeffrey W Swanson, Madeline Stenger, Michele M Easter, Natalie Bareis, Lydia Chwastiak, Lisa B Dixon, Mark J Edlund, Scott Graupensperger, Heidi Guyer, Maria Monroe-DeVita, Mark Olfson, T Scott Stroup, Katherine S Winans, Marvin S Swartz","doi":"10.1371/journal.pmen.0000257","DOIUrl":"10.1371/journal.pmen.0000257","url":null,"abstract":"<p><p>Large numbers of adults with mental disorders in the United States are incarcerated or otherwise involved with the criminal legal system. Evidence is lacking on prevalence of specific psychiatric diagnoses in this population. This article presents results from the Mental and Substance Use Disorders Prevalence Study (MDPS), a national epidemiological survey that assessed lifetime prevalence of schizophrenia-spectrum disorder, and past-year prevalence of bipolar 1, obsessive-compulsive, major depressive, generalized anxiety, and post-traumatic stress disorders using the Structured Clinical Interview for DSM-5 (SCID 5). Diagnoses and demographic characteristics are compared among three populations: (1) imprisoned adults (N=321), (2) adults not incarcerated but with justice involvement in the past year (N=269), and (3) adults with no criminal legal history in the past year (N=5,004). The weighted sample included households, prisons, hospitals, and homeless shelters. About 4 in 10 people with any past-year criminal legal involvement had at least one of these mental disorders. The cumulative prevalence of these disorders was highest among those in prison (41.8%; 95% Confidence Interval (CI): 33.1-50.9%), lower in the community resident population with criminal legal involvement (37.0%; 95% CI: 25.1-50.6%), and lowest among those with no criminal legal involvement in the past year (24.4%; 95% CI: 21.9-27.0%). Findings for schizophrenia-spectrum disorder followed this pattern: prevalence in prison was 6.3% (95% CI 2.7-14.0%), while among community residents with criminal legal involvement prevalence was 4.4% (95% CI: 1.9-10.0%), and among those with no criminal legal involvement it was 1.7% (95% CI: 1.2-2.4%).</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-engaged adaptation and pilot testing of a mental health and substance use screening and referral process in HIV pre-exposure prophylaxis (PrEP) care in the Southern USA.","authors":"Susan Reif, Sarah M Wilson, Elena Wilson, Haley Cooper, Andy Weinhold, Amy Corneli","doi":"10.1371/journal.pmen.0000148","DOIUrl":"10.1371/journal.pmen.0000148","url":null,"abstract":"<p><p>Mental health and substance use concerns are prevalent in HIV pre-exposure prophylaxis (PrEP)-seeking and priority populations (e.g., same gender loving black men (SGLBM)), often negatively affecting health care outcomes. Identifying individuals who could benefit from access to effective behavioral health treatment remains suboptimal among these populations. We utilized a community-informed process to adapt an evidence-based behavioral health identification and linkage model, Screening Brief Intervention and Referral to Treatment (SBIRT), to include mental health screening and increase cultural responsiveness for use in PrEP care. We piloted the adapted SBIRT model (SBIRT PrEP) in a PrEP clinic in the U.S. South that serves primarily SGLBM. A total of 29 SGLBM participated in the pilot, which involved answering screening questions about anxiety, depression, alcohol, and drug use on an iPad. Participants met with a PrEP navigator to review screening results using a guided model that incorporated participant self-determination and motivational interviewing techniques. SGLBM and staff completed surveys and qualitative interviews that assessed their perceptions of the program. Study findings indicated that the adapted SBIRT PrEP model was acceptable and valued by clinic clients and staff. Survey and interview responses indicated that most clients believed that: 1) substance use and mental health screening was appropriate and important to include in PrEP services; 2) the program was an effective way to address mental health and substance use concerns; and 3) the duration of the screening process was acceptable. A majority of clients reported feeling comfortable answering behavior health screening questions on the iPad and discussing the results with the PrEP navigator. A larger, more rigorous trial is needed to further test the SBIRT PrEP model. Identifying methods to better address behavioral health concerns is critical to enhance PrEP participation and improve quality of life for individuals receiving PrEP.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the Health Stigma and Discrimination Framework to psychosis stigma in Malawi.","authors":"Melissa A Stockton, Jack Kramer, Joshua Chienda, Abigail M Morrison, Harriet Akello Tikhiwa, Griffin Sansbury, Alex Zumazuma, Hillary Mortensen, Mwawi Ng'oma, Patrick Nyirongo, Isaac Mtonga, Jackson Devadas, Bonginkosi Chiliza, Anthony Peter Sefasi, Patani Mhango, Bradley N Gaynes, Brian W Pence, Kazione Kulisewa","doi":"10.1371/journal.pmen.0000306","DOIUrl":"10.1371/journal.pmen.0000306","url":null,"abstract":"<p><p>Psychotic disorders are highly stigmatized across the globe, negatively impacting people with psychosis and their families. However, little is known about stigma faced by people with psychosis in sub-Saharan Africa. We developed semi-structured qualitative guides based in a constructivist epistemology and formative research methodologies and conducted 36 in-depth interviews (IDIs) and two focus-group discussions (FGDs) with 12 people with lived experience (PWLE) with psychosis; 12 caregivers of PWLE; six traditional healers; six medical providers; six community leaders (1 FGD); and six religious leaders (1 FGD) in Blantyre, Malawi. We drew from the Health Stigma and Discrimination Framework to delineate the stigmatization process. Participants described key drivers of stigma as lack of awareness, prejudice, stereotypes, and fear. Manifestations included experienced, anticipated, witnessed, perceived, internalized and secondary stigma in the form of insults, gossip, abuse, physical violence, restraints, social exclusion, and employment-based discrimination from family and community. With respect to negative outcomes and health and social impacts, stigma impacted quality of care, resilience, mental health, morbidity, social inclusion and quality of life. In Malawi, stigma is pervasive challenge for PWLE, with severe implication for their health and social wellbeing. In partnership with PWLE, investment into the integration of evidence-based stigma reduction activities into existing psychosis management programs is warranted.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying subgroups of nonsuicidal self-injury: A systematic review.","authors":"Kaylee P Kruzan, Eva Hentges, Israel Ramirez, Jason J Washburn","doi":"10.1371/journal.pmen.0000291","DOIUrl":"10.1371/journal.pmen.0000291","url":null,"abstract":"<p><p>Nonsuicidal self-injury (NSSI) is a complex behavior, and its presentation is marked by significant heterogeneity, complicating efforts to identify and intervene. In this study, we sought to systematically review studies that used data-driven classification methods to identify NSSI subgroups. We searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and Scopus. Article were included if they: (1) focused on NSSI, relative to suicidal self-injury, (2) were published in a peer-reviewed journal, (3) in English language, (4) applied data-driven classification methods to identify subgroups of NSSI and (5) provided details about building the analytical models. Two investigators independently screened abstracts and full-text articles and assessed study quality. In total, 26 articles published between 2008 and 2023 were identified by the search. Studies included data from 7,388 individuals with a history of NSSI and identified 94 subgroups. Many subgroups were defined by NSSI characteristics including NSSI methods, NSSI functions, and lifetime frequency. Others focused on emotion regulation, social competencies, or relationship quality. The quality of study designs and reporting varied. Understanding heterogeneity within NSSI through these subgroups can help inform treatment and intervention personalization.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives and experiences with sleep and recovery among women receiving buprenorphine for opioid use disorder.","authors":"Michelle Eglovitch, Anna Beth Parlier-Ahmad, Alison J Patev, Brenna Cook, Chengxian Shi, Stephanie Violante, Joseph M Dzierzewski, Morgan H James, Caitlin E Martin","doi":"10.1371/journal.pmen.0000250","DOIUrl":"10.1371/journal.pmen.0000250","url":null,"abstract":"<p><p>Sleep issues are prevalent among women receiving medication for opioid use disorder (OUD). However, there is limited data about subjective sleep experiences and how they relate to OUD trajectories. This mixed-methods study explored the intersection of sleep and OUD recovery from the patient perspective among a sample of women receiving medication for OUD. This study enrolled non-pregnant women aged 18-65 who were stabilized on buprenorphine from an outpatient OUD program. Participants were recruited during their routine treatment visits, and enrollment occurred from February 2022 through September 2023. Study participants who endorsed clinically elevated insomnia symptoms on the Insomnia Severity Index (ISI) (≥11 score) (n=50) were included in current study analyses. A sub-sample (n=11) who met the ISI threshold participated in semi-structured interviews. Survey responses were analyzed using descriptive statistics, and interviews were analyzed using applied thematic analysis. The average length of time on buprenorphine for the overall sample was 30 months (range: 2 months - 245 months). Participants reported engagement in healthy sleep behaviors, grouped into four domains: positive sleep related cognitions, sleep environment, sleep restriction, and reducing stimulating activities. Respondents characterized the multidimensional relationship between sleep and health. Women also described how sleep evolves through addiction into recovery, and how good sleep reduces risk of return to substance use. Finally, women discussed the impacts that medication for OUD have on sleep, specifically how they might time their buprenorphine to align with sleep and how it might impact their energy levels. We found that sleep is a dynamic process among this sample of women receiving medication for OUD. Findings are intended to inform future investigations of the mechanisms underlying the sleep-OUD intersection. In addition, this study reflects the importance of incorporating patient perspectives into the development of therapeutics targeting this patient population.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent extracurricular activities and perception of risk of harm from binge drinking.","authors":"Claire Szapary, Jenny Meyer, Claudia-Santi F Fernandes, Tyra Pendergrass Boomer, Lynn Fiellin, Kammarauche Aneni","doi":"10.1371/journal.pmen.0000278","DOIUrl":"10.1371/journal.pmen.0000278","url":null,"abstract":"<p><p>Underage binge drinking can lead to numerous adverse health consequences. Preventing excessive alcohol consumption by targeting perception of risk of harm is one approach with demonstrated success. This study examined the association between participation in extracurricular activities and perception of risk of harm from binge drinking among adolescents. A cross-sectional analysis of adolescents aged 12-17 years was performed using the 2019 National Survey on Drug Use and Health dataset. Participation in any extracurricular activity as well as four types of extracurricular activities (e.g., school-based, community-based, faith-based, and other) were the main independent variables. The primary outcome was perception of risk of harm from weekly binge drinking. Bivariate and multivariate logistic regression models were used to examine this association. Of the 11,870 adolescents included in the analysis, 4.2% reported that weekly binge drinking presented no harm. Compared to adolescents who did not participate in any extracurricular activity, adolescents who participated in one or more extracurricular activity, regardless of type, had 86% higher odds of reporting risk of harm from weekly binge drinking after adjusting for relevant covariates (aOR=1.86, 95% CI: 1.39, 2.49). This finding was similar across all levels of school-based, but different for community, faith-based and other types of activities. Compared to adolescents who did not participate in school-based, adolescent who participated in 1, 2, or 3+ school-based activities were more likely to report that weekly binge drinking was harmful (<i>School</i> AOR 1 activity = 1.75, 95% CI: 1.29, 2.37, AOR 2 activities = 1.83, 95% CI:1.32, 2.53, AOR 3+ activities = 1.91, 95% CI:1.35, 2.75), The association between participation in community-based activities and perception of risk of harm was significant at one or two activities but not at three or more activities (<i>Community</i> AOR 1 activity = 1.35, 95% CI: 1.02, 1.79, AOR 2 activities = 1.47, 95% CI:1.06, 2.02, AOR 3+ activities = 1.41, 95% CI: 0.98, 2.02) while the association between participation in faith-based activities and perception of risk of harm from weekly binge drinking was significant only at 3+ activities (<i>Faith</i> AOR 3+ activities = 2.07, 95% CI: 1.48, 2.88). No significant association was found for participation in other activities in the adjusted model. Our results suggest that participation in extracurricular activities may be a factor that contributes to increased perception of risk of harm from weekly binge drinking among adolescents, but this protective effect may vary by type and level of activity, suggesting different mechanistic pathways. Future studies are needed to further elucidate these findings to inform targeted preventive interventions and policy-level support.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral injury and mental health in healthcare workers are linked to organizational culture and modifiable workplace conditions: Results of a national, mixed-methods study conducted at Veterans Affairs (VA) medical centers during the COVID-19 pandemic.","authors":"Natalie Purcell, Daniel Bertenthal, Hajra Usman, Brandon J Griffin, Shira Maguen, Sarah McGrath, Joanne Spetz, Sylvia J Hysong, Haley Mehlman, Karen H Seal","doi":"10.1371/journal.pmen.0000085","DOIUrl":"10.1371/journal.pmen.0000085","url":null,"abstract":"<p><p>Using mixed methods, we examined drivers of risk for moral injury, mental health symptoms, and burnout among frontline healthcare workers in high-risk Veterans Affairs (VA) clinical settings during the COVID-19 pandemic. Across 21 VA medical centers, 2,004 healthcare workers completed an online survey assessing potential risk factors for moral injury, posttraumatic stress, depression, and burnout. Assessed risk factors included: pandemic exposures; individual worker characteristics; aspects of workplace/organizational culture; and facility performance on standardized measures of care quality, patient satisfaction, and employee satisfaction (extracted from VA administrative data). Among surveyed workers, 39% were at risk for moral injury, 41% for posttraumatic stress, 27% for depression, and 25% for persistent burnout. In generalized linear mixed models, significant predictors of moral injury risk included perceived lack of management support for worker health/safety, supervisor support, coworker support, and empowerment to make job-related decisions-all modifiable workplace factors. Pandemic-related risk factors for moral injury included prolonged short-staffing, denying patient-family visits, and high work-family conflict. Predictors of posttraumatic stress, depression, and burnout were similar. Forty-six surveyed workers completed a follow-up qualitative interview about experiences of moral distress in the workplace, and interview themes aligned closely with survey findings. Rapid qualitative analysis identified protective factors that may reduce moral injury risk, including a collaborative workplace community, engaged leadership, empowerment to make changes in the workplace, and opportunity to process distressing events. We conclude with recommendations to mitigate moral injury risk in healthcare organizations. These include involving workers in discussions of high-stakes decisions that will affect them, creating consistent and clear channels of communication between the frontlines and leaders of the organization, practicing leadership rounding to improve leaders' understanding of the daily work of frontline teams, and collaborating to understand how existing processes and policies may contribute to safety risks and moral conflict.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation of the 5-Question Stigma Indicators in trachoma-affected communities, Ethiopia.","authors":"Misrak Negash, Zerihun Tadesse, Fentie Ambaw, Michael Beka, Tilahun Belete, Melkamu Abte, Kebede Deribe, Julian Eaton, Eve Byrd, E Kelly Callahan, David Addiss, Wim H van Brakel, Abebaw Fekadu, David Macleod, Matthew Burton, Esmael Habtamu","doi":"10.1371/journal.pmen.0000191","DOIUrl":"10.1371/journal.pmen.0000191","url":null,"abstract":"<p><p>Stigma is common in people affected with Neglected Tropical Diseases (NTDs). However, no validated tools are available to assess and monitor stigma in trachoma-affected communities. We tested the cross-cultural equivalence of the 5-question stigma indicator-affected persons (5-QSI-AP) scale in persons with trachomatous trichiasis (TT), the blinding stage of trachoma, and the 5-question stigma indicator-community stigma (5-QSI-CS) scale in person without TT, in Amhara region, Ethiopia. Conceptual, item, semantic, and operational equivalence were assessed through exploratory qualitative methods; measurement equivalence was assessed quantitatively through internal consistency, construct validity, and reproducibility. A total of 390 people participated: 181 were persons with TT, 182 persons without TT, 19 mental health, trachoma, social science, and linguistics experts, and eight interviewers. Items included in both scales were adequately relevant and important to explore stigma in the target culture. Concern about others knowing that they have TT, shame, avoidance by others, and problems getting married or in their marriage were among the issues persons with TT faced in this study community. The 5-QSI-AP had a Cronbach's α of 0.57 for internal consistency and showed adequate discriminant validity where persons with central corneal opacity from TT had higher mean stigma scores than their counterparts. The 5-QSI-CS had a Cronbach's α of 0.70 for internal consistency and a correlation of r = 0.23 with the Social Distance Scale (SDS) for convergent validity. The test-retest reliability analysis between the initial and repeat measures produced an intraclass correlation coefficient of 0.60 and 0.53 for the 5-QSI-AP and 5-QSI-CS respectively, and no evidence of systematic bias in mean stigma scores. The 5-QSI scales have satisfactory cultural validity to assess and monitor stigma in this trachoma-affected Amharic-speaking study population. With further cross-cultural validation, these brief and easy to administer scales would offer the possibility to rapidly measure and monitor stigma associated with NTDs.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 6","pages":"e0000191"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}