Oppression and resistance: An analysis of Muslims' experiences of structural violence.

Discrimination and vilification of Muslims in the United States have historical and political roots. This study explores everyday incidents of marginalization and oppression through the framework of structural violence. Structural violence refers to the systemic inequalities embedded within societal structures that create and support these oppressive conditions. In this community-engaged qualitative study, 10 self-identified Muslims from the northeastern United States were interviewed to understand their lived experiences of structural violence. Using thematic analysis, seven themes were identified: Racialized and xenophobic Islamophobia; normalized violence against Muslims and fear of safety; exclusion, marginalization, and subjugation through policies; Muslims as spokespersons for Islam; Intersecting marginalized identities and oppression; challenges of navigating Muslim identities; resilience and resistance through faith, activism, and community. This study aims to understand and contextualize the experiences of Muslims within a systemic and geopolitical framework. Another critical objective is to promote a discourse to address how academics and clinicians reproduce and maintain structural violence and to instead engage in socially transformative approaches embedded in the principles of decolonizing and mutually-liberating cross-struggle solidarity. These must be cultivated through community-informed intersectional collaborative strategies for dismantling oppressive structures and promoting agency, resilience, activism, and resistance.

Stigma, social anxiety, and illness severity in bipolar disorder: Implications for treatment.

BACKGROUND: Studies indicate that comorbid anxiety disorders predict a more severe course of illness in bipolar disorder (BD). The relatively high prevalence of social anxiety in BD points to the potential role that socio-cultural factors, such as stigma, play in exacerbating the progression of this disorder. Stigma creates social anxiety in affected individuals because it essentially forces them into a vulnerable social status that is marked by public disgrace. Although the etiology of debilitating social anxiety in BD may involve multiple factors, stigma deserves particular clinical attention because research in this area indicates that it is common and its internalization is associated with poor outcome. METHODS: We conducted a literature review using search terms related to stigma, social anxiety, bipolar disorder, illness severity, and outcomes. The electronic databases searched included PsychINFO, PubMed, JSTOR, and EBSCOhost Academic Search Complete with limits set to include articles published in English. RESULTS: The literature indicates that internalized stigma often triggers the core psychological experiences of social anxiety and is highly correlated with clinical and functional outcome in BD. On a psychological level, internalized stigma and social anxiety can create distress that triggers symptoms of BD. From a biological perspective, stigma constitutes a chronic psychosocial stressor that may interact with the pathophysiology of BD in inflammatory ways. CONCLUSIONS: The connection between stigma and social anxiety, and their combined effects on people with BD, carries important implications for psychiatric care. To obtain an accurate clinical formulation, initial evaluations may seek to examine stigma-related experiences and determine their relationship to anxiety symptoms and psychosocial functioning. In addition, direct interventions for reducing the ill effects of stigma in BD deserve clinical attention, because they may carry the potential to enhance outcomes.

Exploring Sociocultural Influences Affecting Body Image in Survivors of Childhood Sexual Assault.

This phenomenological study explored the lived experiences of survivors of childhood sexual assault, their meaning making process of the assault, and how messages from their sociocultural environment affected their relationship with, and perception of, their bodies. Utilizing a social constructivist framework, the research team interviewed eleven (n = 11) participants from a variety of backgrounds who were gender assigned female at birth and had survived childhood sexual assault (CSA). Four major themes emerged from the narratives collected. These include sociocultural impacts which included four subthemes: family relationships, peer relationships, societal and environmental influences, and cultural and ethnic influences; meaning making of the critical event, i.e., childhood sexual assault; self-perception of their bodies; internal processes that have shaped their perceptions and meaning making, i.e., thoughts, feelings, and behaviors. Findings indicate major influence of sociocultural factors in shaping participant's internal processes as survivors of CSA, meaning making, and subsequently self-perceptions of, and relationship with, their bodies. We discuss CSA and body image keeping the intersectionality of the individual, their experiences, and the impact of sociocultural contexts on that intersectionality.

Intervening in a "Sketchy Situation": Exploring the Moral Motivations of College Bystanders of Sexual Assault.

This mixed-methods research explored the moral motivations of undergraduates who identified as bystanders in a situation of potential sexual assault. In the quantitative analysis, we examined the difference between interveners and noninterveners with regard to their scores on the Moral Foundations Questionnaire-30 Item (MFQ-30), which considers five moral foundations from Moral Foundations Theory (MFT) of care/harm, fairness/cheating, loyalty/betrayal, authority/subversion, and sanctity/degradation, as well as measures of bystander attitudes (BAS-R) and rape-myth acceptance (IRMA, modified). Participants who failed to intervene had significantly higher scores on the loyalty/betrayal subscale of the MFQ-30, and showed a trend toward "conservative" values comprising the latter three MFT foundations. Intervening bystanders were also more likely to endorse bystander attitudes, and less likely to endorse rape-myth supporting beliefs. The qualitative analysis examined brief narratives in which participants described their bystander experience and reasoning in the moment. Analysis found a remarkable flexibility with which each moral foundation could be used to support either intervention or abstention. We argue that emphasizing conservative values (based on loyalty, purity, and/or authority) in addition to the typical liberal (justice-based and anti-harm) reasoning may bolster bystander interventions meant to reach all students.

Variation in analytic transparency in recent efficacy studies of antidepressant medication.

The validity of clinical trial results is influenced by researchers' decisions regarding the management of missing data. Inadequate management of missing data has been identified as a significant source of bias that can result in an overestimation of drug efficacy. Transparency related to the management of missing data is essential to assess the strength of evidence reported in publications. In a subset of 17 randomised clinical trials for two new antidepressant medications, we present a case study in which we examined investigators' decisions regarding how to handle missing data and if their chosen method took into account, possible violations of analytic requirements that could affect results. The majority of trials (76%) concluded that there was a benefit of antidepressant treatment and in 94% the methodology for handling missing data was identifiable. Of these, 50% imputed data using the last observation carried forward and half used a mixed-effects model repeated measure approach. Most reports did not provide a rationale for the method used, and no trials described analyses regarding differences between completers and dropouts. Sensitivity analysis was inconsistently reported and correction for multiple comparisons was not uniformly applied. Lack of transparency for analytic choices related to handling of missing data testing was common in this subset of RCTs. Because management of missing data can directly influence the quality of study results, it is critical that journal editors develop and enforce standards for methodological transparency.

Conflict of Interest Policies and Industry Relationships of Guideline Development Group Members: A Cross-Sectional Study of Clinical Practice Guidelines for Depression.

Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.