Table 4.
Direct and indirect effects of coronavirus disease 2019 (COVID-19)-related discrimination on anxiety, distress, depression, and insomnia through the mediating effects of shame and internalized stigma.
| Model | Path | Effect | Boot SE | Boot 95%CI | Effect Size |
|---|---|---|---|---|---|
| D on anxiety | Direct effect | 0.0391 | 0.2757 | −0.5020, 0.5802 | 5.41% |
| Indirect effect | |||||
| Total | 0.6841 | 0.1529 | 0.3889, 0.9918 | 94.59% | |
| D→S→Anxiety | 0.2025 | 0.0887 | 0.0361, 0.3899 | 28.00% | |
| D→IS→Anxiety | 0.4308 | 0.1127 | 0.2204, 0.6633 | 59.57% | |
| D→S→IS→Anxiety | 0.0507 | 0.0254 | 0.008, 0.1077 | 7.01% | |
| D on distress | Direct effect | 0.7689 | 0.3158 | 0.1501, 1.3896 | 46.54% |
| Indirect effect | |||||
| Total | 0.8822 | 0.1795 | 0.5511, 1.2642 | 53.40% | |
| D→S→Distress | 0.1949 | 0.0822 | 0.0411, 0.3669 | 11.80% | |
| D→IS→Distress | 0.6149 | 0.132 | 0.3761, 0.8908 | 37.22% | |
| D→S→IS→Distress | 0.0724 | 0.0366 | 0.0141, 0.1597 | 4.38% | |
| D on depression | Direct effect | 0.0594 | 0.3238 | −0.5759, 0.6948 | 6.97% |
| Indirect effect | |||||
| Total | 0.7929 | 0.1904 | 0.4261, 1.1704 | 93.03% | |
| D→S→Depression | 0.2957 | 0.1266 | 0.0516, 0.5541 | 34.69% | |
| D→IS→Depression | 0.4448 | 0.126 | 0.2046, 0.7034 | 52.19% | |
| D→S→IS→Depression | 0.0524 | 0.0272 | 0.0077, 0.1135 | 6.15% | |
| D on insomnia | Direct effect | 0.1528 | 0.3516 | −0.5372, 0.8428 | 15.73% |
| Indirect effect | |||||
| Total | 0.8184 | 0.1954 | 0.458, 1.2168 | 84.27% | |
| D→S→Insomnia | 0.2334 | 0.1025 | 0.0482, 0.4457 | 24.03% | |
| D→IS→Insomnia | 0.5233 | 0.1435 | 0.2567, 0.8183 | 53.88% | |
| D→S→IS→Insomnia | 0.0616 | 0.0325 | 0.0107, 0.1367 | 6.34% |
Note: D, the experience of discrimination; S, shame; IS, internalized stigma. Models were adjusted for sex, age, and years expected to graduate.