Turan Bulent, Kempf Mirjam-Colette, Konkle-Parker Deborah, Wilson Tracey E, Tien Phyllis C, Wingood Gina, Neilands Torsten B, Johnson Mallory O, Logie Carmen H, Weiser Sheri D, Turan Janet M
Department of Psychology, Koc University, Istanbul, Turkey.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Int J Ment Health Addict. 2025 Apr;23(2):946-963. doi: 10.1007/s11469-023-01147-2. Epub 2023 Aug 31.
In a sample of women living with HIV, we examined whether individual traits fear of negative evaluation and resilience moderate the internalization of poverty stigma that these women experience from others. We also examined the downstream effects of these processes on depression symptoms using moderated serial mediation analyses.
Data were collected annually for 4 years (2016-2020; T1, T2, T3, and T4) from 369 women living with HIV at 4 US cities using validated measures. Moderation effects were evaluated examining simple slopes at one standard deviation above and below the mean of the moderator. In all mediation analyses utilizing bootstrapping, we used the independent variable measured at T1, the mediators measured at subsequent visits (T2 and T3), and the outcome at the last visit (T4) to preserve the temporal sequence among the independent variable, mediators, and outcome variable. We also adjusted for T1 values of all mediators and outcome variables in analyses.
Women with stronger fears of negative evaluation by others or lower dispositional resilience had stronger associations between experienced poverty stigma and internalized poverty stigma. Internalized poverty stigma (T2) mediated the association between experienced poverty stigma (T1) and depression symptoms (T4); this mediated association was moderated by fear of negative evaluation and resilience (T1). Finally, internalized poverty stigma (T2) and avoidance coping (T3) were serial mediators in the association between experienced poverty stigma (T1) and depression symptoms (T4), moderated by fear of negative evaluation and resilience.
Understanding factors that minimize internalization of stigma and buffer its negative effects on mental health can inform interventions to improve health outcomes of individuals with stigmatized conditions.
在一组感染艾滋病毒的女性样本中，我们研究了个体特质（对负面评价的恐惧和心理韧性）是否会调节这些女性所经历的来自他人的贫困污名内化。我们还使用调节序列中介分析研究了这些过程对抑郁症状的下游影响。
在4年时间（2016 - 2020年；T1、T2、T3和T4）里，每年从美国4个城市的369名感染艾滋病毒的女性中收集数据，采用经过验证的测量方法。通过检查调节变量均值上下一个标准差处的简单斜率来评估调节效应。在所有使用自抽样法的中介分析中，我们使用在T1测量的自变量、在后续访视（T2和T3）测量的中介变量以及在最后一次访视（T4）测量的结果变量，以保持自变量、中介变量和结果变量之间的时间顺序。我们还在分析中对所有中介变量和结果变量的T1值进行了调整。
对他人负面评价恐惧较强或性格韧性较低的女性，在经历的贫困污名与内化的贫困污名之间的关联更强。内化的贫困污名（T2）介导了经历的贫困污名（T1）与抑郁症状（T4）之间的关联；这种中介关联受到对负面评价的恐惧和心理韧性（T1）的调节。最后，内化的贫困污名（T2）和回避应对（T3）是经历的贫困污名（T1）与抑郁症状（T4）之间关联的序列中介变量，受到对负面评价的恐惧和心理韧性的调节。
了解能尽量减少污名内化并缓冲其对心理健康负面影响的因素，可为改善有污名状况个体的健康结果的干预措施提供信息。
