The Mediating Role of Internalized Stigma and Shame on the Relationship between COVID-19 Related Discrimination and Mental Health Outcomes among Back-to-School Students in Wuhan

Int J Environ Res Public Health. 2020 Dec 10;17(24):9237. doi: 10.3390/ijerph17249237.

Abstract

Outbreaks of an epidemic, such as coronavirus disease 2019 (COVID-19), always brings about far-ranging discrimination and stigmatization to the epicenter. This was a cross-sectional survey conducted to assess experienced discrimination, internalized stigma, shame, and mental health (anxiety, depression, distress, insomnia) among college students who merely had a perceived linkage with COVID-19, and explore the linkage between discrimination and negative mental health outcomes through the mediating effects of shame and internalized stigma. A total of 995 participants (53% female) were involved in this study, in which 40.9% of college students were reported to be discriminated against because of their experience in Wuhan. The experience of COVID-19-related discrimination is indirectly associated with anxiety, depression, and insomnia, in which shame and internalized stigma play a complete mediating effect. Meanwhile, it is both directly and indirectly associated with distress through shame and internalized stigma. The findings of this study suggest that COVID-19-related discrimination is associated with shame and internalized stigma, which in turn predict psychological symptoms over time.

Keywords: COVID-19; college students; discrimination; internalized stigma; mental health; shame.

MeSH terms

  • Adolescent
  • Adult
  • COVID-19 / psychology*
  • China
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Female
  • Humans
  • Male
  • Mental Health*
  • Shame*
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Social Discrimination*
  • Social Stigma*
  • Students
  • Universities
  • Young Adult