by Emanuele Fino, Moubadda Assi, Ismael Maatouk, and Rusi Jaspal

Identity Change Research Group, NTU Psychology Department

As we enter the new year, there is little doubt that the spread of the novel coronavirus and its associated disease have changed, and will continue to change, how we see the world and ourselves in the months and years to come. Evidence on the impact of the pandemic on healthcare, science, economy, environment, let alone our behaviours and wellbeing, is abundant. Moreover, we all have our personal accounts of how coronavirus has affected our own identities. However, when it comes to the analysis of changes at a societal level, it is still difficult to estimate the toll that the virus is taking (and most probably will continue to take) on different social groups. In this article, we summarise recent research conducted by members of the newly-formed Identity Change Research Group (ICRG) to explore perceived risk and identity threat as major drivers of health and wellbeing inequalities, particularly within marginalised communities.

By marginalised communities, we refer to groups within societies that are either officially or unofficially pushed to the margins, often because of their minority status. These groups often receive differential treatment and/or access to material and non-material resources (Moscovici et al., 1985). This can be determined by factors, such as their ethnicity, religion, sexual orientation, language, or even physical and mental health conditions, to cite some. Nevertheless, the characteristics and the extent to which such marginalisation is perpetrated may differ across social and cultural contexts, and in this process, tolerance and acceptance of diverse social identities play a key role.

Social identity-based stigma may be resisted by members of marginalised communities (Jaspal, 2011), in a number of domains. However, research reports show that disparities in the perception and exposure to risk and healthcare outcomes for members of different groups in British society still exist. In particular, a document recently published by Health Education England has evidenced a higher risk of contracting COVID-19 among individuals from marginalised groups such as those inhabiting deprived areas of the country, and Black, Asian and Minority Ethnic (BAME) individuals, compared to other groups, recognising social and demographic factors as predictors of inequalities in health and wellbeing. We have also found that BAME people are at increased risk of poor mental health during the pandemic due to social inequalities (Jaspal & Lopes, 2021). Therefore, it is not surprising that individuals from different social groups differ in their risk appraisal of it, which has significant implications for their health and wellbeing.

Photo by Anna Shvets from Pexels

In this regard, aiming to assess perceived risk effectively, we developed the COVID-19 Own Risk Appraisal Scale (CORAS) (Jaspal, Fino, & Breakwell, 2020). In this study, we adapted an extant psychometric scale that had been originally developed to measure own risk to HIV/ AIDS to assess one’s own risk of contracting the novel coronavirus and its associated disease. Results showed that the CORAS is reliable and that scores correlate highly with scores on the Fear of COVID-19 Scale (Ahorsu et al., 2020). We found no differential item functioning by gender, age, or ethnicity, making the scale suitable to measure perceived risk in diverse social and demographic groups. We have also designed and developed the COVID-19 Preventive Behaviors Index (Breakwell, Fino & Jaspal, 2021), aimed to assess the likelihood of adopting behaviours designed to limit one’s risk of contracting and/or transmitting coronavirus to others. However, it is clear more research will be necessary to improve our measurement and understanding of the impact of perceived risk on the lives, health, and wellbeing of individuals belonging to marginalised groups. It must aim to identify effective psychological and behavioural coping strategies, and to provide evidence-based recommendations on necessary policy and intervention to mitigate the existing divide.

In Lebanon, gay, bisexual and other men who have sex with men are at particular risk of identity threat, psychological adversity and poor health outcomes. A 2018 national IBBS study has confirmed a concentrated HIV epidemic with prevalence of 12% among gay and bisexual men and a population size estimation between 16,000 and 20,000 making this a high priority population. Although sexual health services in Lebanon are poorly integrated in the overall healthcare system, access to preventive and treatment services is made available to key populations through social organizations and private clinics (Maatouk & Jaspal, 2019). However, the wellbeing of gay and bisexual men in Lebanon continue to be shaped by their unique childhood experiences, their daily exposure to potentially threatening social representations, emerging stressors related to the financial crisis and the COVID-19 pandemic, as well as difficulties in access to adaptive coping strategies (Jaspal, Assi & Maatouk, 2020). In fact, ongoing qualitative interviews conducted by Moubadda Assi with gay and bisexual men in Lebanon are highlighting how essential financial and social independence are to the expression and enhancement of gay identity. With the current financial crisis that is transversally cutting through the Lebanese society, the wellbeing of gay and bisexual men is severely threatened as many of them are reportedly having to move back in with their parents where they may be at risk. Given that many gay and bisexual men in Lebanon express concerns about coming out to their parents, the risk of identity threat associated with “living a double life” is increased, with implications for behaviour, health, and wellbeing.

Identity change is an inevitable dimension of the human condition. However, the relations between identity, health and wellbeing in marginalised groups are complex. The available evidence suggests that marginalised groups are more susceptible to identity threat but that they may have decreased access to resources that can facilitate effective coping. The Identity Change Research Group strives to understand the psychology of human identity, how it changes and, crucially, how people cope with these changes. To do so effectively, it is our belief that the discipline of psychology will need to continue to innovate: developing robust measurement, looking beyond our own cultural contexts and, above it, asking challenging questions to improve the lives of individuals from different groups within society.

About the authors

Emanuele Fino is Senior Lecturer in Psychology at Nottingham Trent University.

Moubadda Assi and Ismael Maatouk are PhD students in Psychology at Nottingham Trent University.

Rusi Jaspal is Professor of Psychology at Nottingham Trent University, UK, where he leads the Identity Change Research Group. You can follow him on Twitter @ProfRJaspal

References

Ahorsu, D. K., Lin, C.-Y., Imani, V., Saffari, M., Griffiths, M. D., & Pakpour, A. H. (2020). The Fear of COVID-19 Scale: Development and Initial Validation. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-020-00270-8

Assi, M., Maatouk, I., & Jaspal, R. (2020). Psychological distress and self-harm in a religiously diverse sample of university students in Lebanon. Mental Health, Religion & Culture, 23(7), 591-605. https://doi.org/10.1080/13674676.2020.1788524

Jaspal, R., Fino, E., & Breakwell, G. M. (2020). The COVID-19 Own Risk Appraisal Scale (CORAS): Development and validation in two samples from the United Kingdom. Journal of Health Psychology. http://doi.org/10.1177/1359105320967429

Breakwell, G. M., Fino, E., & Jaspal, R. (2021). The COVID-19 Preventive Behaviours Index: Development and validation in two samples from the United Kingdom. Evaluation & the Health Professions. https://doi.org/10.1177/0163278720983416

Breakwell, G. M., & Jaspal, R. (2020). Identity change, uncertainty and mistrust in relation to fear and risk of COVID-19. Journal of Risk Research. https://doi.org/10.1080/13669877.2020.1864011

Jaspal, R. (2011). Caste, Social Stigma and Identity Processes (2011). Psychology and Developing Societies, 23, 27–62. https://doi.org/10.1177/097133361002300102

Jaspal, R. (2016). Gay Men’s Construction and Management of Identity on Grindr. Sexuality & Culture, 21, 187-204. https://doi.org/10.1007/s12119-016-9389-3

Jaspal, R., & Breakwell, G. M. (Eds.) (2014). Identity Process Theory: Identity, Social Action and Social Change. Cambridge University Press.

Jaspal, R., Assi, M., & Maatouk, I. (2020). The potential impact of the COVID-19 pandemic on mental health outcomes in societies with economic and political instability: the case of Lebanon. Mental Health Review Journal, 25(3), 215-219. https://doi.org/10.1108/MHRJ-05-2020-0027

Jaspal, R., & Lopes, B. (2021). Discrimination and mental health outcomes among British Black and South Asian people during the COVID-19 outbreak in the United Kingdom. Mental Health, Religion & Culture. https://doi.org/10.1080/13674676.2020.1871328

Maatouk, I., & Jaspal, R. (2019). HIV in men who have sex with men in Lebanon: Clinical and psychosocial aspects. BMJ Journal of Sexual & Reproductive Health, 45(3), 175-176. http://doi.org/10.1136/bmjsrh-2018-200199

Moscovici, S., Mugny, G., & van Avermaet E. (Eds) (1985). Perspectives on minority influence. Cambridge University Press.

Public Health England (2020). Disparities in the risk and outcomes of COVID-19.