The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19.

BACKGROUND: During the COVID-19 pandemic, increased social media usage has led to worsened mental health outcomes for many people. Moreover, due to the sociopolitical climate during the pandemic, the prevalence of online racial discrimination has contributed to worsening psychological well-being. With increases in anti-Asian hate, Asian and Asian American social media users may experience the negative effects of online racial discrimination in addition to the reduced psychological well-being resulting from exposure to online COVID-19 content. OBJECTIVE: This study aims to investigate the impact of COVID-19-related social media use and exposure to online racial discrimination during the pandemic on the mental health outcomes (ie, anxiety, depression, and secondary traumatic stress [STS]) of Asian Americans compared with those of non-Asian Americans. In addition, this study explores the mediating role of negative affect and the moderating role of racial/ethnic identification. METHODS: An online survey was conducted through Amazon Mechanical Turk and a university-wide research portal from March 3 to March 15, 2021. A total of 1147 participants took the survey. Participants' social media usage related to COVID-19 and exposure to 2 online forms of racial discrimination (individual and vicarious), mental health outcomes (anxiety, depression, and STS), racial/ethnic identification, negative affect, and demographics were assessed. RESULTS: Our results showed that COVID-19-related social media use, individual discrimination, and vicarious discrimination were predictors of negative mental health outcomes (anxiety, depression, and STS). Asian Americans reported higher vicarious discrimination than Latinx and White Americans, but Asian Americans' mental health outcomes did not differ substantially from those of the other racial/ethnic groups. Racial/ethnic identification moderated the relationship between both types of discrimination and STS, and negative affect served as a mediator between both types of discrimination and all 3 mental health outcomes. CONCLUSIONS: These results suggest that social media exposure continues to have a dire effect on mental health during the COVID-19 pandemic. This study helps to contextualize the rise of anti-Asian American hate and its impact on mental health outcomes in the United States.

The Influence of Linguistic Agency and Causality Attribution in Support-seeking about Depression on Perceived Stigma and Support Messages.

This experiment examined how two language features-linguistic agency and assignment of causality-of online support-seekers' messages regarding depression influenced viewers' perceived stigma and features of their support messages. Participants (N = 254) read and responded to an online support-seeking post about depression. Our results revealed that personal stigma toward a depressed individual was lower when the individual disclosed a biological cause for the depression and assigned agency to depression than agency to human. Additionally, when agency was assigned to depression with a biological rather than non-biological cause, more positive emotion words were utilized in participants' response posts. Cognitive process words were used more often in response to messages with non-biological causality than biological causality.

Effects of addiction science on conceived freewill and responsibility.

Although there is speculation that medicalization of addiction undermines conceived agency, only relatively modest effects have been reported. Research participants generally have ideas about addiction that are informed both by personal experience and by media, and their views may not be wholly updated in response to study-information. Here we examine the potential impact of addiction science theories on perceived volition and responsibility by considering the issues in the context of a hypothetical new drug, "Z." Participants (N = 662) were provided one of three functional accounts that each corresponded to a prominent theory within addiction science: incentive-sensitization, impaired self-control, and habit-system dominance. For half of participants, additional neuroscience mechanism information was included with the functional account. Across explanations, the inclusion of mechanism information was associated with significantly less perceived volition and marginal reduction in blame, For several measures, there was a significant or marginally significant interaction between which addiction explanation was used and whether mechanism information was included, with mechanism generally having the largest impact given the impaired self-control explanation of addiction and little evidence of impact given the incentive-sensitization explanation of addiction. Taken together, these results suggest robust effects of addiction science on judgments of agency when presented in the context of a novel addiction. It is unclear whether a sustained scientific consensus around an existing theory could produce a similar impact on how people understand real addictive behavior.

Online comments about psychiatric neurosurgery and psychopharmacological interventions: Public perceptions and concerns.

The field of biological psychiatry is controversial, with both academics and members of the public questioning the validity and the responsible use of psychiatric technological interventions. The field of neuroethics provides insight into these controversies by examining key themes that characterize specific topics, attitudes, and reasoning tools that people use to evaluate interventions in the brain and mind. This study offers new empirical neuroethical insights into how the public responds to the use and development of psychiatric technological interventions by comparing how the public evaluates pharmacological and neurosurgical psychiatric interventions, in the context of online comments on news media articles about these topics. We analyzed 1142 comments from 108 articles dealing with psychopharmacological and psychiatric neurosurgery interventions on websites of major circulation USA newspapers and magazines published between 2005 and 2015. Personal anecdote, medical professional issues, medicalization, social issues, disadvantages, scientific issues and cautionary realism were among the main themes raised by commenters. The insights derived from the comments can contribute to improving communication between professionals and the public as well as to incorporating the public's views in policy decisions about psychiatric interventions.

Comparison of philosophical concerns between professionals and the public regarding two psychiatric treatments.

BACKGROUND: Psychiatric interventions are a contested area in medicine, not only because of their history of abuses, but also because their therapeutic goal is to affect emotions, thoughts, beliefs, and behaviors that are regarded as pathological. Because psychiatric interventions affect characteristics that seem central to who we are, they raise issues regarding identity, autonomy, and personal responsibility for one's own well-being. Our study addresses two questions: (1) Do the public and academic researchers understand the philosophical stakes of these technologies in the same way? Following from this, (2) to what extent does the specific type of psychiatric technology affect the issues these two groups raise? This study compares how ethical issues regarding neurosurgical and pharmaceutical psychiatric interventions are discussed among the public and in the professional community of academic medicine and bioethics. METHODS: We analyzed (1) online public comments and (2) the medical and bioethics literature, comparing the discussions of pharmacological and neurosurgical interventions in psychiatry in each source. RESULTS: Overall, the public discussed philosophical issues less frequently than academics. For the two types of psychiatric interventions, we found differences between the academic literature and public comments among all themes, except for personal responsibility. CONCLUSIONS: These findings reveal some of the similarities and discrepancies in how philosophical issues associated with psychiatric treatments are discussed in professional circles and among the public. Further research into what causes these discrepancies is crucial.

Conflicts of interest and industry professional relationships in psychiatric neurosurgery: a comparative literature review.

OBJECTIVE The research required to establish that psychiatric treatments are effective often depends on collaboration between academic clinical researchers and industry. Some of the goals of clinical practice and those of commercial developers of psychiatric therapies overlap, such as developing safe and effective treatments. However, there might also be incompatible goals; physicians aim to provide the best care they can to their patients, whereas the medical industry ultimately aims to develop therapies that are commercially successful. In some cases, however, clinical research may be aiming both at improved patient care and commercial success. It is in these cases that a conflict of interest (COI) arises. The goal of this study was to identify differences and commonalities regarding COIs between 2 kinds of somatic psychiatric interventions: pharmacological and neurosurgical. METHODS The authors conducted a study focused on professional concerns regarding pharmacological and neurosurgical psychiatric interventions. They used medical and bioethics journal articles as an indicator of professionals' concerns and carried out a thematic content analysis of peer-reviewed articles published between 1960 and 2015, using PubMed and Google Scholar. RESULTS One hundred thirty-seven relevant articles were identified, of which 86 papers focused primarily on psychopharmacology and 51 on neurosurgery. The intervention most discussed in the psychiatric neurosurgery data set was deep brain stimulation (n = 42). While there were no significant differences at the level of categories, pharmacological and neurosurgical interventions differ in the underlying themes discussed. Two issues widely discussed in the articles on pharmaceutical interventions, but largely neglected in the neurosurgery articles, were medical professional issues and industry involvement. CONCLUSIONS COIs are a neglected issue in the discussion of ethics concerns regarding medical devices in psychiatry. Yet as these interventions become more common, it is important to address them in part through learning from the discussion regarding COIs in the pharmaceutical industry and by developing approaches to address those aspects of COIs that are unique to the medical device industry.

Incidental findings during a surgical procedure-current practice and ethical implications.

AIM: Sometimes during an elective surgical procedure, an abnormality is found which is unrelated to the scheduled procedure. In many instances, immediate treatment of this unexpected pathology is in the patient's medical interests, however, specific patient consent has not been obtained. This study investigates current surgical practice when confronted by an incidental finding (IF), as well as surgeons' views on informed consent in this context. METHOD: An online survey was sent to all practicing surgeons and surgical trainees within New Zealand. Respondents were presented with hypothetical scenarios involving IFs and asked to decide whether or not they would proceed with treatment. Opinion was sought on the factors influencing such decisions and the need for a clause within surgical consent documents to prompt discussion about IFs. RESULTS: 151/450 (33.6%) surgeons and trainees responded. Immediate treatment was more likely with IFs of greater clinical significance, lower-risk procedures and where there was prior consent for IF treatment. A proportion of surgeons did not follow these trends. Although a great deal of variation exists in the way that IFs are dealt with in the consent process, the majority of respondents (111/129, 86%) favoured a clause within a consent form that prompts discussion and seeks consent for the treatment of IFs. CONCLUSION: Responses to the IF scenarios were generally consistent with good practice. While variation in decision-making is to be expected, some decisions were concerning. Most surgeons agree that a clause within the consent form should trigger a discussion of IFs during the consent process.

Incidental findings during a surgical procedure-patient and public perspectives.

AIM: During a surgical procedure, incidental findings (IF) may be found and often the immediate treatment is in the patient's best interest. Due to the nature of IFs, specific patient consent cannot be obtained under such circumstances. The dilemma is whether the surgeon should proceed or delay until consent is obtained, as there are significant ethical and legal implications. Following an earlier study of surgeons' preferences for IF management, this report investigates patient and public preferences. METHOD: A questionnaire presented hypothetical scenarios involving IFs and samples of patients and public respondents reported their preference to proceed with treatment or have their surgeon wait to obtain consent. Opinion was sought regarding factors influencing their decisions and if general surgical consent procedures should cover IFs. RESULTS: A sample of 331 respondents from the general public and 368 elective surgery patients were surveyed. Results showed an overall preference to proceed with treatment in 75.1% of the hypothetical scenarios, which increased with IF severity and decreased with procedural risk. Thematic analysis of open-ended questions revealed a number of factors influencing preferences with avoidance of further surgery being most common. Results showed most respondents preferred for information provided in general consent forms though not all were comfortable about this. CONCLUSION: Patient and public preferences to proceed with treatment in hypothetical scenarios were generally consistent with surgeons' reported practice when faced with IFs. The data suggest that an IF clause in the consenting process could help surgeons make clinical decisions best aligned with individual patients' preferences.