Internal stigmatization in patients with chronic migraine and medication overuse headache.

OBJECTIVES: Internalized stigma can have profound effects on how individuals with migraines and other primary headache disorders see themselves and their quality of life. We aimed to investigate internalized stigma in patients with chronic migraines and medication overuse headaches. METHODS: A total of 57 patients (52 women, 5 men) were included in the study, 26 of these patients were affected by chronic migraine, 31 of them were affected by medication overuse headache and chronic migraine. The Internalized Stigma Scale in Mental Illness (Ristsher's stigmatization scale) and General Health Questionnaire were applied to all patients. RESULTS: In Ristsher's stigmatization scale, which measures internalization of stigma, internalized stigmatization was more significant in patients with medication overuse headache than in patients with chronic migraine compared to groups (p:0.05). The subtitle of alienation was statistically significant when the groups were compared to all subscales in the form of alienation, confirmation of stereotypes, perceived discrimination, social withdrawal and resistance to stigma (p:0.05). DISCUSSION: Although internal stigmatize has been observed in chronic migraine patients, medication overuse headache is also a type of headache with intense stigma. In addition, this internal stigma perhaps plays an active role in the transformation of chronic migraine patients to medication overuse headaches patient.

Development and validation of a social alienation predictive model for older maintenance hemodialysis patients based on latent profile analysis-a cross-sectional study.

BACKGROUND: Social alienation refers to the state of feeling isolated, helpless, and unsatisfied due to maintaining distance from others or avoiding social interaction and activities. This phenomenon is caused by a lack of social skills, social anxiety, physical health problems, and other reasons. Older maintenance hemodialysis patients are exposed to a higher risk of social alienation. However, previous studies have been performed using the total score of the scale, which does not allow the identification of the characteristics of various patient groups with different levels of social alienation. In contrast, latent profile analysis can classify individuals into different categories based on continuous observational indicators, which improves accuracy and provides a more objective assessment by accounting for the uncertainty of variables. Given the concealed nature of social alienation and the differences in characteristics and treatment measures between different profiles, developing a predictive model for social alienation in older maintenance hemodialysis patients holds significance. OBJECTIVE: To explore the latent profile analysis of social alienation in older maintenance hemodialysis patients and to develop and validate a predictive model for social alienation in this population. METHODS: A total of 350 older maintenance hemodialysis patients were selected as the study subjects using convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, the Generalized Alienation Scale, and the Self-Perceived Burden Scale. Based on the results of the Generalized Alienation Scale, a latent profile analysis was performed, followed by univariate analysis and multinomial logistic regression to develop a predictive model. The effectiveness of the predictive model was evaluated in terms of its authenticity, reliability, and predictive ability. RESULTS: Three hundred nineteen valid questionnaires were collected. The social alienation of older maintenance hemodialysis patients based on latent profile analysis were divided into three profiles, which were named the low/medium/high-symptom groups, comprising 21%, 38.9%, and 40.1% of participants, respectively. Based on male, monthly social activity hours, Age-Adjusted Charlson Comorbidity Index, dialysis age, and Self-Perceived Burden Scale, a predictive model of social alienation for older maintenance hemodialysis patients was developed, and the Hosmer-Lemeshow tests showed no statistical significance (P > 0.05). The model has high predictive efficiency in authenticity, reliability and predictability. CONCLUSION: Older maintenance hemodialysis patients exhibited moderate to high levels of social alienation. The latent profile analysis based method was used to divide patients into low/medium/high-symptom profiles, and the predictive model demonstrates excellent authenticity, reliability, and predictability.

Linking abusive supervision to service sabotage through work alienation in nurses: A cross-sectional study.

BACKGROUND: Abusive supervision has detrimental effects on nurses, but the mechanisms connecting abusive supervision to negative outcomes for nurses have not been well-established in the nursing literature. AIM: This study aimed to investigate whether work alienation mediates the relationship between abusive supervision and nurses' service sabotage. METHODS: This descriptive cross-sectional study was conducted from November to December 2021 with 204 nurses working at a teaching hospital in Damanhour, Egypt. Data were collected using a demographic information form, the Abusive Supervision Scale, the Work Alienation Scale and the Service Sabotage Scale. Study hypotheses were evaluated using structural equation modelling. RESULTS: Our findings revealed a significant association between abusive supervision, work alienation, and service sabotage among nurses. Abusive supervision was found to be linked to nurses' service sabotage through work alienation. CONCLUSION: Our study suggests that nurses who are subject to abusive supervision are more likely to feel alienated, which increases the probability of them engaging in behaviours that have a negative impact on the quality of care they provide. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

I have never been invited-A cross-sectional explorative study of family members' experiences of encounters with healthcare professionals in diabetes care.

AIM: To explore the experiences of family members of adult persons with type 1 diabetes concerning both the approach of healthcare professionals and feelings of alienation in encounters with professional diabetes care. METHODS: A cross-sectional explorative quantitative and qualitative design. The Family Involvement and Alienation Questionnaire-Revised (FIAQ-R), including an open-ended question, was answered by 37 family members of adult persons with type 1 diabetes. Analyses included descriptive statistics and qualitative analysis. The study has received ethical approval. RESULTS: Family members rated the approach of the healthcare professionals as being somewhat positive and considered that the approach towards them is important. They only felt partially alienated from the professional care. Qualitative data revealed that the family members often lacked direct access to the professional care and that their involvement was dependent on their relationship with the person with diabetes. Findings highlighted that the family members' wish to be involved in the care was sometimes unanswered. CONCLUSION: Based on the findings, it is reasonable to stress the importance of considering family members' perspectives and involving them in diabetes care to improve overall patient support.

For the good of the children-Life and ethical values when undergoing paternal alienation and involuntary loss of paternity.

BACKGROUND AND AIM: Today there is an aspiration and desire for fathers to be caring masculinities that build long-term father-child relationships and emotional presence with their children. Previous research shows that life changes where fathers are deprived of the opportunity for equal parenting and close contact with their children affect the fathers' lives and mental health. The aim of this caring science study is thereby to gain a deeper understanding of life and ethical values when undergoing paternal alienation and experiencing involuntary loss of paternity. DESIGN, RESEARCH METHODS, AND PARTICIPANTS: The study has a qualitative design. The data collection was carried out in 2021 through individual in-depth interviews according to Kvale and Brinkmann. The five fathers who participated in the interviews had experiences of undergoing paternal alienation and involuntary loss of paternity. The interviews were analysed with a reflexive thematic analysis according to Braun and Clarke. RESULTS: Three main themes emerged. Putting yourself aside includes forgetting one's own needs and prioritising the children's and being the best version of oneself for them. In playing with the cards you have been dealt lies an acceptance of life as it has become and also a responsibility not to let the grief take over, by creating new patterns for everyday life and holding up hope. Keeping your dignity as a human being includes being heard, affirmed and consoled, and a form of re-awakening one's dignity as a human being. CONCLUSION: It is fundamental to understand the grief, longing and sacrifice that paternal alienation and involuntary loss of paternity cause human life and how every day can be a struggle to hold on to hope, find comfort and reconcile with the situation. The fundamental foundation that makes life worth living is love and responsibility for the good of the children.

Heterogeneity of work alienation and its relationship with job embeddedness among Chinese nurses: a cross-sectional study using latent profile analysis.

OBJECTIVE: To identify the distinct profiles of work alienation among Chinese nurses, examine the demographic factors associated with profile memberships, and then explore the relationship between latent categories of work alienation and job embeddedness. METHODS: A cross-sectional survey of 523 nurses was conducted from July to August 2023. Latent profile analysis (LPA) was performed to identify distinct profiles of nurses based on three aspects: powerlessness, helplessness, and meaningfulness. A multinomial logistic regression analysis was conducted to explore the predictors of profile membership. Hierarchical regression analysis was carried out to examine the association between profile memberships and job embeddedness. RESULTS: Three subgroups of work alienation of nurses were identified: 23.1%, 57.8%, and 19.1% in the low work alienation group (profile 1), the moderate work alienation group (profile 3), and the high work alienation group (profile 2), respectively. Nurses with college degrees were more likely to be grouped into moderate work alienation. Nurses who did not work night shifts were more likely to have low or moderate levels of work alienation. Nurses earning 2,000-3,000 and 3,001-5,000 yuan per month were likely to be in the low work alienation group. The different categories of work alienation significantly predicted job embeddedness among nurses (ΔR2 = 0.103, p < 0.001). CONCLUSIONS: Work alienation has an important impact on clinical nurses' job embeddedness. Nursing managers should pay attention to the differences in individual work alienation status and adopt reasonable management strategies to improve the level of job embeddedness, ensure the quality of care, and reduce nursing turnover.

Examining generational differences as a moderator of extreme-context perception and its impact on work alienation organizational outcomes: Implications for the workplace and remote work transformation.

There is no doubt that extreme contexts (e.g., war zones and pandemics) represent substantial disruptions that force many companies to rethink the way they do business. With so much of the workforce now working remotely and concerns about resulting work alienation, we must ask this question: How can this be translated into the generational divide in workplaces based in extreme contexts? Using COVID-19 as an example trigger of extreme-context experience, therefore, we investigate generation as a moderator of the effects of extreme-context perception upon anxiety leading to alienation with subsequent behavioral outcomes on job insecurity, job satisfaction, and organizational citizenship behavior (OCB). A time-lagged survey procedure yielded 219 valid responses from a three-generation sample of employees working in multiple service organizations. The data were analyzed using partial least squares structural equation modeling (PLS-SEM). Our analysis suggested that intense extreme-context perception led to elevated anxiety and alienation, which, in turn, heightened job insecurity and worsened job satisfaction and OCB outcomes. Finally, during the experience of extreme-context times, generation was found to moderate our model, such that both Generation Y and Generation Z experienced higher anxiety due to extreme-context perception and hence higher job insecurity due to alienation compared with Generation X respondents. Our results endorse the criticality of implementing agile and generationally non-sectarian management for effectively functioning generationally diverse workforces in pandemic times.

Work alienation and quality of work life among nurses: A descriptive cross-sectional study.

BACKGROUND: Work alienation in nursing can create various problems that affect the quality of work life of nurses, which should be addressed from different perspectives. AIMS: This study investigated the relationship between work alienation and the quality of work life, aiming to determine the factors affecting nurses' quality of work life. DESIGN: This is a descriptive and cross-sectional study that used the STROBE guidelines to prepare this study report. METHODS: The study was conducted between March and June 2022 in Turkey with 303 nurses. It used an online questionnaire with a simple random sampling. Data were collected using a descriptive characteristics form, the Work Alienation Scale, and the Quality of Nursing Work Life Scale. The data were analyzed with Pearson correlation and multiple regression analysis. RESULTS: There was a significant negative correlation between work alienation and the quality of work life. Four independent variables with 58.2% impact on the nurses' quality of work life were identified, including participation in the decision-making process, the ability to use initiative during the production of the service, the significance of the work for the individual, and the type of institution. CONCLUSIONS: The nurses' work alienation score was moderate, and their quality of work life score was high. An increase in the feeling of work alienation statistically decreased the quality of work life. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurses who experience work alienation may face a decline in their quality of work life that may have an adverse effect on their work performance and work satisfaction.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support.

BACKGROUND: COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. METHODS: The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. RESULTS: Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01). CONCLUSION: Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

The relationship between role ambiguity, emotional exhaustion and work alienation among chinese nurses two years after COVID-19 pandemic: a cross-sectional study.

BACKGROUND: work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators. METHODS: A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling. RESULTS: work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion (r1 = 0.521, r2 = 0.755; p < .01), and role ambiguity was positively correlated with emotional exhaustion (r = 0.512; p < .01). A mediating effect of emotional exhaustion between role ambiguity and work alienation held (mediating effect of 0.288, 95% CI: 0.221-0.369, accounting for 74.8% of the total effect). CONCLUSION: Role ambiguity has a significant direct effect on nurses' feelings of alienation and exacerbates alienation through emotional exhaustion. Clarifying roles at work and being less emotionally drained are effective ways to reduce nurses' feelings of alienation.

Parental alienation - a valid experience?

BACKGROUND: The phenomenon of 'parental alienation' is controversial and little explored in the Nordic countries. We wanted to investigate whether parental alienation is a valid concept and how it is perceived in a Nordic context. MATERIAL AND METHOD: The study was based on an online survey where the participants were self-recruited. We received responses from 1212 participants. Bivariate and multivariate models were used to test the associations between parental alienation and gender, other intimate partner violence, depressive health problems and reduced well-being. RESULTS: Visitation sabotage and parental alienation are realities for both fathers and mothers. It was most frequently directed at fathers, but such behaviour is not gender specific. Eight different alienation strategies have high internal reliability, and all items contribute to high Cronbach's alpha. Construct validity was confirmed by the fact that parental alienation is strongly associated with visitation sabotage and with other forms of destructive relational behaviour. Visitation sabotage and false accusations increase gradually with the degree of parental alienation. The construct validity of parental alienation was also confirmed by dose-response associations with both mental ill-health and impaired well-being in adjusted analyses. CONCLUSIONS: The phenomenon of parental alienation is recognized among parents as a form of harmful behaviour where both mothers and fathers suffer. The construct validity was supported in this study. Such behaviour should be recognized as a form of domestic violence by professional communities in health and social services and be subject to legal action.

When meaning in life protects against fear of death: The moderating role of self-alienation.

OBJECTIVE: A sense of meaning in life (MIL) is thought to help protect people against experiencing explicit anxiety about death. However, the experience of meaning is complex and subjective and may relate to death anxiety in nuanced ways. We examine how self-alienation-a feeling of not knowing/being disconnected from one's self-might moderate the relationship between MIL and death anxiety. METHOD: Across five studies, we tested the hypothesis that MIL would negatively predict death anxiety more strongly for people relatively low in self-alienation. These studies were similar in design and included exploratory, confirmatory, and pre-registered tests. RESULTS: A meta-regression across our five studies (N = 2001) provided clear evidence that MIL was most strongly associated with lower death anxiety at low self-alienation. We also observed that MIL was positively associated with death anxiety at high self-alienation. These effects were consistent in direction but inconsistent in strength. CONCLUSIONS: We interpreted these results as evidence that MIL is existentially protective when experienced in combination with a relatively strong, clear, and connected sense of self. In contrast, MIL may be existentially problematic when people feel relatively unaware and disconnected from themselves. These findings align with aspects of terror management theory and highlight the potentially complex ways that MIL might relate to death anxiety.

Effect of prosocial behavior on school bullying victimization among children and adolescents: Peer and student-teacher relationships as mediators.

INTRODUCTION: In this study, we examined the relationship between prosocial behavior and school bullying victimization in children and adolescents. We also tested the mediating effects of peer alienation and student-teacher closeness, as well as the moderating effect of the educational stage. METHODS: In total, 538 children and adolescents were recruited from three suburban schools in Beijing, China (252 boys, 286 girls; mean age = 12.47; 237 elementary school students, 101 middle school students, and 200 high school students). The participants were asked to complete the measures of prosocial behavior, peer alienation, and student-teacher closeness at the initial time point and reported school bullying victimization 3 months later. RESULTS: We found that prosocial behavior was directly and negatively associated with traditional bullying victimization (i.e., physical, nonphysical, and relational); however, it had no direct association with cyberbullying victimization. Prosocial behavior was indirectly associated with school bullying victimization (except in the relational dimension) via peer alienation, but no indirect effect of student-teacher closeness was found. Besides, the associations between prosocial behavior, peer alienation, student-teacher closeness, and bullying victimization were found equally among elementary, middle, and high school students. CONCLUSIONS: The findings suggest that prosocial behavior is an important factor associated with decreased school bullying victimization, and peer relationships play a mediating role in this association. Our study extends the current understanding of prosocial behavior primarily as a consequence of child and adolescent development to an antecedent (of school bullying victimization), which contributes to a more comprehensive view of prosocial behavior.

Scholarly rumors: Citation analysis of vast misinformation regarding parental alienation theory.

Misinformation is widespread in political discourse, mental health literature, and hard science. This article describes recurrent publication of the same misinformation regarding parental alienation (PA), that is, variations of the statement: "PA theory assumes that the favored parent has caused PA in the child simply because the child refuses to have a relationship with the rejected parent, without identifying or proving alienating behaviors by the favored parent." Ninety-four examples of the same misinformation were identified and subjected to citation analysis using Gephi software, which displays the links between citing material and cited material. The recurrent misinformation reported here is not trivial; these statements are significant misrepresentations of PA theory. Plausible explanations for this trail of misinformation are the psychological mindset of the authors (i.e., confirmation bias) and the authors' writing skills (e.g., sloppy research practices such as persistent use of secondary sources for their information). The authors of this article recommend that publications containing significant misinformation should be corrected or retracted.

Southeast and East Asian immigrant women's transnational postpartum experiences: A meta-ethnography.

The increase in births to Southeast and East Asian (SEEA) immigrants in their adopted countries is of international importance. SEEA women experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of SEEA women in the literature. The purpose of this meta-ethnography is to synthesise the qualitative findings from different research studies examining the experiences of SEEA immigrant women during the first 4-6 weeks of the postpartum period and has been written in adherence with enhancing transparency in reporting the synthesis of qualitative research (PRISMA). Noblit and Hare's meta-ethnographic approach was used. Seven articles (four qualitative and three mixed-methods studies) were reviewed, analysed and synthesised. Four themes emerged: two were facilitators of birth culture (availability and quality of social support and maternity care provider cultural knowledge and response) and two were barriers to birth culture (lack of structural and social support and cultural alienation after childbirth). Due to lack of structural and social support in SEEA immigrant women's adopted countries, they also experienced social and economic hardships after childbirth and made conscious decisions to modify their postpartum cultural practices out of convenience and practicality. SEEA immigrant women also experienced discrimination from maternity care providers, which prevented them from fully engaging in postpartum cultural practices. Maternity care providers can advocate and intervene for SEEA immigrant women by eliciting any postpartum cultural beliefs, assess their social and economic needs early on in prenatal care and make culturally congruent referrals based on those assessments.

Anorexia Nervosa in Adolescence: A Comprehensive Study of Multidimensional Factors Associated with Symptom Severity 1 Year Following the Diagnosis.

The overarching goal of this study was to examine the unique contribution of psychological, familial, and friendship factors in explaining anorexia nervosa (AN) symptom severity 1 year following diagnosis among a sample of adolescent girls. A second objective was to determine whether friendship factors mediated the association between psychological and/or familial factors and AN symptom severity. This study included 143 adolescent girls under the age of 18 diagnosed with AN (M = 14.84, SD = 1.31). Participants were recruited from specialized eating disorder treatment programs. At admission (T1), participants completed a set of self-report questionnaires measuring psychological, familial, and friendship factors. AN symptom severity was assessed 1 year later (T2). Results of hierarchical regression analysis revealed that greater general psychological maladjustment at T1 (b = .26; se = .03; p = .00) was associated with greater AN symptom severity at T2. Greater alienation from friends at T1 (b = 1.20, se = .53, p = .03) also predicted greater AN symptom severity at T2, above and beyond the influence of adolescent girls' general psychological maladjustment. Finally, the mediating role of alienation from friends in the association between general psychological maladjustment at T1 and AN symptom severity at T2 was also identified. AN is a multidimensional disorder with a prognosis that involves both psychological and social factors. The results stemming from the present study shed light on the role of peer as a mechanism through which general psychological maladjustment is linked to AN symptom severity 1 year following diagnosis.

Social acceleration, alienation, and resonance: Hartmut Rosa's writings applied to nursing.

This article aims to present the life and work of German thinker Hartmut Rosa as a philosopher of interest for nursing. Although his theoretical framework remains fairly unknown in the nursing domain, its main key concepts open up a philosophical and sociological approach that can contribute to the understanding of a wide range of study phenomena related to nurses, nursing, and healthcare. The concepts of social acceleration, alienation, and resonance are useful to explore healthcare organizations' performance by bringing the time dimension of modernity to the center; to grasp nurses' experiences of caring for patients; and to understand nurses as agents endowed with the capacity to deploy their political agency to create alternative forms of relationship to themselves, to others, and the world, challenging the institutional order of healthcare organizations when it fails to resonate with their professional ethos. In this article, we propose Hartmut Rosa's theoretical framework as a new and inspiring phenomenological and critical lens that should be further explored to advance knowledge concerning phenomena that are found at the crossroads of the nursing domain and other fields of knowledge.

Autistic traits predict social avoidance and distress: The chain mediating role of perceived stress and interpersonal alienation.

Social avoidance and distress are the primary aspects of social anxiety. Nonautistic people with high levels of autistic traits are more likely to exhibit social avoidance and distress. However, research has yet to reveal how autistic traits induce social avoidance and distress. To fill this gap, the present study recruited 708 participants to complete the 25-item Autism Spectrum Quotient, Social Avoidance and Distress Scale, Chinese Perceived Stress Scale, and Interpersonal Alienation Subscale. The results indicated that autistic traits significantly predicted social avoidance and distress in nonautistic people. In addition, autistic traits induced social avoidance and distress through perceived stress and interpersonal alienation, respectively. Importantly, perceived stress and interpersonal alienation (including the subdimensions of interpersonal alienation: sense of loneliness, sense of social isolation, and alienation between family members) partially mediated the relationships between autistic traits and social avoidance and distress. Overall, autistic traits predict social avoidance and distress via perceived stress and interpersonal alienation. This finding extends the hypothetical model of clinical anxiety in autism spectrum disorders. Furthermore, reducing perceived stress and interpersonal alienation in nonautistic people with high levels of autistic traits may be a valid intervention method to prevent and eliminate their social avoidance and distress.

The effects of post-COVID-19 fatigue in nurses on organizational outcomes.

This study was conducted to determine the effects of fatigue in nurses with confirmed COVID-19 infection on organizational outcomes. The study was carried out with the participation of 200 nurses who had tested positive for COVID-19 in the last eighteen months and had COVID-19-related fatigue complaints. Data were collected between October 2022 and February 2023 using a questionnaire consisting of the Chalder Fatigue Scale, the Work Alienation Scale, the Turnover Intention Scale, and the Employee Performance Scale. Fatigue was the most common symptom of COVID-19 in this study, as in other results. The number of being infected with COVID-19 and education levels were found to be significant predictors of post-COVID-19 fatigue. Post-COVID-19 fatigue had an effect on turnover intention and alienation to work, but it did not affect employee performance. In this study, the effects of post-COVID-19 fatigue on organizational outcomes such as employee performance, turnover intention, and work alienation were determined. Therefore, regardless of its source, fatigue should be dealt with managerially, and preventive policies and procedures should be developed.

Classified out of society? How educational classification induces political alienation through feelings of misrecognition.

Less educated citizens are both descriptively and substantively outnumbered by higher educated citizens in political and societal institutions. While social science has devoted much time to explain why such education effects exist, it has largely neglected the role of feelings of misrecognition in inducing political alienation among less educated citizens. We argue that education has become so central in processes of economic and social stratification that it is likely that less educated citizens feel misrecognized due to their marginal presence in societal and political institutions, which would then lead to their political alienation. This would in particular be the case in societies that are more 'schooled', that is, societies where schooling is a more dominant and steering institution. We analysed data from 49,261 individuals in 34 European countries and found that feelings of misrecognition were strongly related to political distrust, dissatisfaction with democracy, and vote abstention. These relations explained a significant part of the difference between higher and less educated citizens in political alienation. We also found that this mediation effect was larger in countries that are more schooled.