Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma.
The recent outbreak of coronavirus disease 2019 (COVID-19) has been extremely stressful and has produced fear and anxiety throughout the population, representing a psychological emergency. This work aimed at presenting a mental health first aid service established within an Italian university public hospital context to address four different population targets (i.e., people vulnerable to mental health problems, health-care professionals, people in isolation, and general citizenship). Specifically, the organizational structure comprising four different areas (i.e., management, clinical, communication, and research) and first data collected from the foundation of the service until 3 May 2020 are presented. Findings indicated that anxiety and fear of contagion were the main motivations prompting both the general population and health-care professionals to ask for a psychological help. Furthermore, findings indicate that clients’ current quality of life was perceived as lower than in the past but also that imagined in the future, highlighting the importance of psychological first aid interventions. This service may represent an example for helping mental health professionals in developing similar services in their local realities, promoting health and individual and community resilience.
Transgender and gender nonconforming (TGNC) people experience high rates of minority stress and associated risk for negative health outcomes. However, during the last years, significant positive socio-cultural changes have happened, and younger cohorts of TGNC individuals are having diverse experiences compared to older cohorts. By integrating the minority stress theory and the life course perspective, this cross-sectional, web-based study aimed to explore in 197 Italian TGNC people aged 18 to 54 years (M = 29.82, SD = 9.64) whether the average ages of gender identity milestones (i.e., first insights about being TGNC, self-labeling as a TGNC person, and coming out), minority stress, and mental health vary among three generational cohorts (i.e., Generation Z, Millennials, and Generation X). Compared with older cohorts, younger participants: (a) were more likely to be in the trans-masculine spectrum; (b) self-labeled as TGNC and came out earlier; (c) had more negative expectations and lower levels of disclosure; and (d) had higher levels of mental health problems. No generational differences related to first insights about being TGNC and distal minority stressors were found. Furthermore, compared with binary individuals, participants with a non-binary identity: (a) reported later ages for the gender identity milestones; (b) had higher negative expectations; and (c) had higher levels of mental health problems. Overall, our findings indicated that changes in the social environments have a limited impact on stigmatization processes and mental health of Italian TGNC people.
Trust in governmental organizations is a crucial factor in terms of encouraging people to conform to public health regulations, such as those recommended to slow down the spread of SARS-CoV-2. However, trust in governmental organizations tends to decline over time, reducing the compliance with public health regulations. This study aimed at exploring, first, the role of future anxiety and fatigue as serial mediators of the relationship between trust in governmental organizations and protective behaviors, and, secondly, the role of Covid-19 risk perception as a moderator between fatigue and protective behaviors. A total of 948 Italian participants (302 males and 646 females), ranged from 18 to 80 years (M = 27.20, SD = 11.01), answered an online survey during the second wave of the Covid-19 outbreak. A moderated serial mediation model was performed using a structural equation modeling. The results indicate that: (1) a higher trust in Italian governmental organizations was associated with a greater compliance in terms of adopting protective behaviors; (2) a lower trust in Italian governmental organizations increased anxiety about the future which, in turn, raised levels of fatigue, leading, finally, to a reduction in the levels of protective behaviors; and (3) as the perceived risk related to Covid-19 increased, the effect of fatigue on protective behaviors decreased. The findings of the current study may provide indications for public health policy on how to increase compliance with the recommended behaviors to be adopted in order to decrease the spread of the SARS-CoV-2.
Background:Although different personality traits have often been associated with different levels of mental activity and cognitive functioning, no previous studies have evaluated the association in a sample that mirrors a nationally-representative sample of elderly individuals.Objective:To evaluate the association between personality traits and neurocognitive functioning among individuals 51 years and older using the Cognition and Aging in the USA (CogUSA) database.Methods:We analyzed the association between personality traits and neurocognitive scores derived from Waves I and II of the study. Neurocognitive functions were modeled as an outcome variable using the Big Five Personality Traits as predictors.Results:All personality traits were associated with higher education except Conscientiousness. Older age was associated with higher levels of the Agreeableness and Openness traits. Extraversion, Conscientiousness and Openness were positively associated with increased neurocognitive function and self-rated present memory. Extraversion and Openness also had a positive association with long-term retrieval. Agreeableness was negatively associated with several neurocognitive functions, while Neuroticism was negatively associated with memory and cognitive effort.Conclusion:Extraversion, Conscientiousness and Openness personality traits are associated with good cognitive health. Individuals scoring high in Neuroticism and Agreeableness might benefit from tailored cognitive interventions to prevent age-related cognitive decline.
Bisexual people are a strongly stigmatized population experiencing health disparities caused by social stigmatization. The predominant framework helping to understand these health disparities and the impact of stigma on mental health of social groups belonging to a sexual minority identity constitutes the minority stress theory. In Italy, studies assessing this model in bisexual populations are very limited. Within this framework, the current study aimed at assessing in 381 Italian bisexual individuals (62 men and 319 women) the effects of anti-bisexual discrimination, proximal stressors (i.e., anticipated binegativity, internalized binegativity, and outness), and resilience on psychological distress. The results suggested that only anti-bisexual discrimination and internalized binegativity were positively associated with psychological distress, and that resilience was negatively associated with mental health issues. Furthermore, the results suggested that internalized binegativity mediated the relationship between anti-bisexual discrimination and mental health problems. No moderating effect of resilience was found. This is the first study to have thoroughly applied minority stress in Italian bisexual people, providing Italian clinicians and researchers with an outline of the associations between minority stress, stigma, resilience, and psychological distress within this population.
BackgroundThe Hospital Acquired Condition Strategy (HACS) denies payment for venous thromboembolism (VTE) after total knee arthroplasty (TKA). The intention is to reduce complications and associated costs, while improving the quality of care by mandating VTE prophylaxis. We applied a system dynamics model to estimate the impact of HACS on VTE rates, and potential unintended consequences such as increased rates of bleeding and infection and decreased access for patients who might benefit from TKA.Methods and FindingsThe system dynamics model uses a series of patient stocks including the number needing TKA, deemed ineligible, receiving TKA, and harmed due to surgical complication. The flow of patients between stocks is determined by a series of causal elements such as rates of exclusion, surgery and complications. The number of patients harmed due to VTE, bleeding or exclusion were modeled by year by comparing patient stocks that results in scenarios with and without HACS. The percentage of TKA patients experiencing VTE decreased approximately 3-fold with HACS. This decrease in VTE was offset by an increased rate of bleeding and infection. Moreover, results from the model suggest HACS could exclude 1.5% or half a million patients who might benefit from knee replacement through 2020.ConclusionSystem dynamics modeling indicates HACS will have the intended consequence of reducing VTE rates. However, an unintended consequence of the policy might be increased potential harm resulting from over administration of prophylaxis, as well as exclusion of a large population of patients who might benefit from TKA.
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