Longer-Term Mental Health Consequences of COVID-19 Infection: Moderation by Race and Socioeconomic Status.

OBJECTIVE: While evidence suggests that the mental health symptoms of COVID-19 can persist for several months following infection, little is known about the longer-term mental health effects and whether certain sociodemographic groups may be particularly impacted. This cross-sectional study aimed to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status. METHODS: 277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection completed a 45-minute online questionnaire battery. RESULTS: People with a history of COVID-19 had greater depressive (d = 0.24), anxiety (d = 0.34), post-traumatic stress disorder (PTSD) (d = 0.32), and insomnia (d = 0.31) symptoms than those without a history of COVID-19. These differences remained for anxiety, PTSD, and insomnia symptoms after adjusting for age, sex, race, education, income, employment status, body mass index, and smoking status. No differences were detected for perceived stress and general psychopathology. People with a history of COVID-19 had more than double the odds of clinically significant symptoms of anxiety (OR = 2.22) and PTSD (OR = 2.40). Education, but not race, income, or employment status, moderated relationships of interest such that COVID-19 status was more strongly and positively associated with all the mental health outcomes for those with fewer years of education. CONCLUSION: The mental health consequences of COVID-19 may be significant, widespread, and persistent for at least 6 months post-infection and may increase as years of education decreases.

Assessment of Student Perspectives on Improving Wellness in Medical School: Qualitative Results from a Cross-Sectional Survey of Medical Students in Florida.

PURPOSE: Helping medical students maintain wellbeing has become an important concern, as many medical students report a decline in their mental health during the course of their training. To improve students' wellbeing, some schools have implemented wellness programs into their curricula. While there is growing research about the effectiveness of these programs, little is known about what medical students themselves desire to support their wellbeing. This study aimed to assess medical student perspectives regarding the most effective ways to promote wellness during medical school. PARTICIPANTS AND METHODS: To address this gap in the literature, a survey was administered to medical students at the nine medical schools in the state of Florida. Participants included 864 medical students, whose anonymous responses were analyzed descriptively as well as qualitatively to determine major themes. RESULTS: Students provided novel suggestions and recommendations, including ideas for curricular additions and changes, cultural changes within schools, promoting positive behaviors and extracurricular activities, and providing resources for students. CONCLUSION: Based on the participants' responses, it is evident that wellness is an important issue to medical students and, given the variety of suggestions, schools should strongly consider what wellness changes to implement and whether participation in them should be mandatory. The results of this study will be a resource to medical schools and educators who are considering curricular changes to address medical student wellbeing.

From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma.

OBJECTIVE: Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future and how anticipation of stigma in turn predicts greater stigma internalization. METHOD: Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. RESULTS: Correlational analyses indicated that more experiences of discrimination due to one's mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Experiences of discrimination over one's lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma.

Identity consolidation and health risk behaviors in college students.

OBJECTIVES: To investigate the protective role of personal identity consolidation against health risk behaviors in college-attending emerging adults. METHODS: A multisite sample of 1546 college students completed measures of personal identity consolidation and recent risk behavior engagement. RESULTS: Multivariate Poisson regression indicated that personal identity consolidation was negatively related to binge drinking, illicit drug use, sexual risk behaviors, and risky driving. These findings were consistent across gender, ethnicity, and place of residence. CONCLUSIONS: A consolidated sense of personal identity may protect college-attending emerging adults from health-compromising behaviors. Health professionals could incorporate an identity development component into college health programming.