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Familial transmission of mental illnesses and health behaviors is well established. However, little research has examined familial transmission of mental health help-seeking behaviors despite social science theoretical traditions that support its occurrence including social learning theory and the network episode model. Among parent-adolescent dyads, extant literature supports consideration of adolescent-autonomy versus parent-gatekeeping according to whether or not parents recognize a mental health problem in their adolescent. Given this, we examined familial transmission of self-reported mental health help-seeking among parent-adolescent dyads over an 18-month period from a school-based study (N = 422; Texas, USA). Generalized estimating equations tested the effect of multiple forms of parent help-seeking on similar forms of adolescent help-seeking, controlling for personal/family characteristics. We also examined interaction by parent recognition of a mental health problem in their adolescent to discern unique intergenerational processes across these subgroups of parent-adolescent dyads. Owing to effect modification by parent problem recognition (p<0.01), two unique familial transmission of help-seeking pathways emerged. When parent problem recognition was present, parent self help-seeking history reduced adolescent help-seeking net of controls. In contrast, when parent problem recognition was absent, parent self help-seeking history increased adolescent help-seeking net of controls. Our findings provide evidence of familial transmission of mental health help-seeking behaviors, but the direction of influence fundamentally depends on parent recognition of a mental health problem in their adolescent in order to reveal intergenerationally transmitted processes. The findings support our hypotheses that familial transmission of help-seeking starts early in adolescence and is likely influenced by parent modeling and gatekeeping, though explanations for the patterns observed, such as short- and long-term positive and negative mixed impacts of past help-seeking experiences of parents, require further study to ascertain.
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INTRODUCTION: This study aimed to identify disparate health-related marketing across English- and Spanish-language television networks in New York City, ultimately to inform policy that can counteract disproportionate health-related marketing that provides harmful content to and withholds beneficial information from Latinx populations. METHODS: A 2-week composite sample of primetime English-language (National Broadcasting Company and Columbia Broadcasting System) and Spanish-language (Telemundo and Univision) television networks from YouTube television was randomly drawn from September 7, 2022 to September 27, 2022 in New York City. A total of 9,314 health-related television advertisements were identified for systematic media content analysis and coded into categories: alcohol, core or noncore foods/beverages, mental health/tobacco prevention, health insurance, medical centers, and pharmaceuticals. Analyses conducted in 2022-2024 included intercoder reliability and descriptive and rate difference estimates using total advertisement broadcasting time in the full sample and subsamples by language networks on YouTube television. RESULTS: Spanish television networks broadcast greater health-adverse advertisements per hour for alcohol (rate difference=4.91; 95% CI=3.96, 5.85) and noncore foods/beverages (rate difference=13.43; 95% CI=11.52, 15.34) and fewer health-beneficial advertisements per hour for mental health/tobacco prevention (rate difference= -0.99; 95% CI= -1.45, -0.54), health insurance (rate difference= -1.00; 95% CI= -1.44, -0.57), medical centers (rate difference= -0.55; 95% CI= -1.23, 0.12), and pharmaceuticals (rate difference= -5.72; 95% CI= -7.32, -4.11) than New York City primetime English television networks. CONCLUSIONS: Multilevel policy innovation and implementation are required to mitigate primetime television marketing strategies that contribute to health inequities.
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BACKGROUND: Since 1950, public communication about the neurobiological-psychosocial basis of mental illness from the diathesis-stress model has promoted reception to treatment yet violent/dangerous stereotypes have increased during this period. Moreover, public mental health communication efforts have predominantly diffused in English-language media, excluding Spanish/Latinx media and its consumers from these efforts. To inform future mental health communication strategies, this study leverages high versus low diffusion of public mental health communication across English and Spanish/Latinx media to examine public mental health communication effects on stigma and treatment beliefs via neurobiological-psychosocial beliefs. METHODS: A quota sample of 2058 U.S.-based Latinx residents ages 13-86 with diverse language/cultural media preferences was recruited to self-complete a survey about mental health information acquisition in 2021. Assessments ascertained frequency of Spanish/Latinx and English media use and mental health content scanning and seeking (αâ¯=â¯0.86-0.94); and items from the General Social Survey about mental illness neurobiological-psychosocial causal beliefs (αâ¯=â¯0.72)-genetics, brain chemistry, environment, stress; treatment beliefs-mental illness improves with treatment or on its own; and stigma beliefs-violent/dangerous and bad character stereotypes and unwillingness to socialize with a person with mental illness. Structural equation models estimated total, direct, and indirect effects of Spanish/Latinx and English media exposures on treatment and stigma beliefs via neurobiological-psychosocial beliefs, net individual/family factors. RESULTS: Spanish/Latinx media reduced, while English media increased, neurobiological-psychosocial beliefs (pâ¯<â¯0.01). Neurobiological-psychosocial beliefs, in turn, increased treatment and stigma beliefs (pâ¯<â¯0.01), simultaneously. Indirect pathways were also significant (pâ¯<â¯0.05). Proportion mediated on treatment beliefs was one-third for Spanish/Latinx and two-thirds for English media. Proportion mediated on stigma beliefs for all media exposures averaged ≥1. CONCLUSIONS: While consumers of Spanish/Latinx media report lower neurobiological-psychosocial knowledge that impedes treatment beliefs, consumers of English media report greater neurobiological-psychosocial and treatment knowledge and, consequently, more stigma. Innovation in public mental health communication is needed to counter stigma and health inequity.
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Hispânico ou Latino , Transtornos Mentais , Estigma Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Comunicação em Saúde/métodos , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Meios de Comunicação de Massa , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Transtornos Mentais/etnologia , Saúde Mental/etnologia , Inquéritos e Questionários , Estados UnidosRESUMO
While significant mental illness stigma disparities across race/ethnicity and gender exist, little is known about the efficacy of anti-stigma interventions in reducing these intersectional disparities. We examine the two-year effects of school-based anti-stigma interventions on race/ethnic and gender intersectional stigma disparities among adolescents. An ethnically and socioeconomically diverse sixth grade sample (N = 302) self-completed surveys assessing stigma before randomly receiving an anti-stigma curriculum and/or contact intervention versus no intervention. Surveys were also self-completed two-years post-intervention. Stigma measures assessed general mental illness knowledge/attitudes, awareness/action, and social distance. Stigma towards peers with specific mental illnesses were examined using vignettes-two adolescent characters were described as having bipolar (Julia) and social anxiety (David) disorder. Race/ethnicity and gender were cross-classified into six intersectional groups (Latina/o, Non-Latina/o Black, and Non-Latina/o White girls and boys). Linear regressions adjusting for poverty and mental illness familiarity examined anti-stigma intervention effects across intersectional groups in sixth and eighth grade. The school-based anti-stigma intervention reduced intersectional stigma disparities over the two-year study period. While Non-Latino Black boys and Latino boys/girls reported greater disparities in stigma at baseline compared to Non-Latina White girls, these disparities (14 total) were predominantly eliminated in the two-year follow-up following receipt of the curriculum and contact components to just one remaining disparity post-intervention among Non-Latino Black boys. By identifying differences in how school-based anti-stigma interventions reduce mental illness stigma for unique race/ethnic and gender intersectional groups, we can better understand how to shape future anti-stigma interventions for diverse intersectional populations.
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COVID-19 created a global crisis, exacerbating disparities in social determinants of health (SDOH) and mental health (MH). Research on pandemic-related MH and help-seeking is scarce, especially among high-risk populations such as college/university students. We examined self-rated MH and psychological distress, the perceived need for MH services/support, and the use of MH services across the SDOH among college/university students during the start of the pandemic. Data from the COVID-19 Texas College Student Experiences Survey (n = 746) include full- and part-time undergraduate/graduate students. Regressions examined self-rated MH, psychological distress, perceived need, and service use across SDOH, controlling for pre-pandemic MH, age, gender, and race/ethnicity. Economic stability was associated with higher risk of poor MH and need for MH services/support. Aspects of the social/community context protected student MH, especially among foreign-born students. Racial discrimination was associated with both greater psychological distress and use of services. Finally, beliefs related to the sufficiency of available institutional MH resources shaped perceived need for and use of services. Although the worst of the pandemic is behind us, the inequitable distribution of the SDOH among students is unwavering. Demand for MH support is high, requiring higher education institutions to better mobilize MH services to meet the needs of students from diverse social contexts.
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COVID-19 , Saúde Mental , Humanos , COVID-19/epidemiologia , Pandemias , Texas/epidemiologia , Utilização de Instalações e Serviços , Estudantes/psicologiaRESUMO
OBJECTIVES: We developed and evaluated new media-related health information acquisition measures for U.S.-based Latino populations. METHODS: In 2021, a sample of U.S.-based Latino adults (N = 1574) self-completed a 20-min survey of health information acquisition measures across three language/cultural dimensions: Spanish media, Latino-tailored media in English, and general media in English. Socio-demographics were also ascertained. Means and standard deviations for the health acquisition measures were adjusted for age and sex and reported across nativity status. RESULTS: The sample was diverse across age, gender, race, ethnicity, socioeconomic status, migration, and language competency. Internal consistency reliability of developed scales was excellent overall and within age, gender, race, ethnicity, and socioeconomic subgroups (Cronbach's alphas = 0.86-0.94). English media scales had higher means overall indicating higher prolonged quantity (i.e., dosage) than Spanish media scales. In contrast, standard deviations for Spanish media scales were higher overall indicating broader reach at lower doses than English media scales. CONCLUSIONS: Findings suggest English-language media is popular among Latino populations overall. However, Spanish-language media retains broad reach through both passive and active exposure. Our findings demonstrate the value of including more nuanced measurement of health information acquisition such as the scales developed in this study to improve health promotion among Latino populations.
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Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Comportamento de Busca de Informação , Saúde Mental , Adulto , Humanos , Idioma , Reprodutibilidade dos Testes , Estados UnidosRESUMO
The COVID-19 pandemic has disrupted the wellbeing of the general US population, but even more so among Latinx young adults. The current study provides a detailed picture of the emotional wellbeing and coping of Latinx young adults during the first summer of the pandemic. Six virtual focus groups (n = 21) were conducted between May and August of 2020 with a community-based sample of Latinx young adults to explore (1) how the pandemic affected wellbeing and (2) how they coped with pandemic-related stress. Contextualistic thematic analysis identified important themes and subthemes. Perceived stressors impacting emotional wellbeing yielded one overarching theme: COVID-related disruptions in the participants' environment. To manage this heightened stress, another overarching theme was self-care and intentionality during the pandemic. Future studies should examine the wellbeing of young adults across social contexts and at more recent stages of the pandemic. Findings from this study suggest culturally- and developmentally-tailored interventions are needed as this population navigates contextual stress during a sensitive period in their life.
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COVID-19 , Humanos , Adulto Jovem , Pandemias , Adaptação Psicológica , Emoções , Hispânico ou LatinoRESUMO
For many Latinx young adults, COVID-19 has exposed exclusionary policies that heighten risk for contracting the virus and that leave them and their parents unprotected. This study has a dual purpose; first, to quantitatively examine immigration policy impacts of discrimination, isolation, threats to family, and vulnerability, and their association to economic consequences experienced by Latinx young adults in Central Texas during the initial months of the COVID-19 pandemic. Second, to qualitatively explore how policy impacts affected Latinx young adults during the pandemic, and the coping mechanisms they utilized to minimize these impacts. Quantitative results show that on average, Latinx young adults (N = 83) reported low discrimination and isolation but moderate threats to family and vulnerability, with rates of isolation and vulnerability higher for foreign-born than U.S.-born Latinx young adults. Perceived discrimination due to one's own or family immigration status was associated with economic hardship. Qualitative findings show that Latinx young adults (n = 21) experienced (a) precarious conditions that pose a threat of COVID-19 infection for Latinxs, (b) parental job loss due to vulnerable employment leads to deprivation, and (c) policies that disproportionally discriminate against the Latinx community and exclude them from vital services. Despite these challenges, participants also drew on resilience and expressed hope for the future. The article concludes with implications for policymakers and practitioners to provide protections and services to Latinx young adults and their family members.
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COVID-19 , Emigração e Imigração , Adulto Jovem , Humanos , Pandemias , Políticas , EmpregoRESUMO
Mental illness stigma is a significant barrier to utilizing mental health services for young populations. Few studies have evaluated how specific stigma dimensions relate to help-seeking and recommendations among adolescents. We examined how the stigma dimensions of labeling, stereotypes, and separation/discrimination influenced self-reported help-seeking behaviors of adolescents and recommendations for hypothetical peers with a mental health problem. Longitudinal data (four assessments) from a study evaluating the effectiveness of three anti-stigma interventions (curriculum, contact, materials, versus control) among adolescents were analyzed (n=396). Help-seeking outcomes comprised services in formal (e.g., doctor), informal (e.g., friend), or school-based (e.g., school counselor) settings. Generalized estimating equations tested associations of labeling, stereotypes, and separation/discrimination on help-seeking for a personal problem and recommendations for vignette characters described as having bipolar depression or social anxiety disorder. Adolescents were more likely to make help-seeking recommendations for peers with mental health problems than they were to seek help for a problem of their own. Labeling was a strong predictor of self-reported help-seeking and recommendations. Mental health literacy, an indicator for low negative stereotypes, was related to increased recommendations but not self-reported help-seeking. Positive stigma action and awareness-high cognizance of stigma and how to engage in proactive behaviors towards treating and destigmatizing mental illness-increased help-seeking in formal and informal settings for oneself. Finally, separation/discrimination did not prevent self-reported help-seeking, but it did increase peer recommendations in certain settings. Stigma did not always influence or interfere with help-seeking in the same way when the help-seeker was oneself versus a peer.
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Latinx young adults 18-25 years old face unique challenges that disproportionately put them at high risk of experiencing health as well as economic and social burden due to the Coronavirus disease (COVID-19) pandemic. The present study examined how economic and psychosocial consequences as a result of the pandemic were associated with mental health issues among a community sample of Latinx young adults (N = 83) from Central Texas. Participants completed an online survey of COVID-related experiences and mental health needs. The survey asked about personal and family experiences of COVID-19 in two significant areas: (a) economic strain (e.g., economic hardship, food insecurity) and (b) psychosocial burden (e.g., losing relationships, substance use). Regression analyses examined the association of COVID-19 consequences on level of mental health symptoms and clinically significant outcomes. Relative to economic consequences, psychosocial consequences due to the COVID-19 pandemic were associated with higher levels of mental health symptoms. In contrast, in few cases, economic strain resultant from the pandemic was correlated with clinically significant outcomes among this sample. Collectively, findings suggest that the costs of the pandemic do not only pertain to mortality from illness but also to morbidity as it relates to deteriorating social circumstances and mental health. Findings from this study call for immediate attention to implement policies and programs to help mitigate the economic and social-emotional consequences of COVID-19 such as easy access to low-cost virtual mental health resources to Latinx young adults.
Los adultos jóvenes latinos de 18 a 25 años enfrentan desafíos únicos que los ponen de manera desproporcionada en un alto riesgo de sufrir consecuencias de salud, económicas y sociales debido a la pandemia del COVID-19. El estudio presente examinó cómo las consecuencias económicas y psicosociales a raíz de la pandemia se asociaron con problemas de salud mental en una muestra comunitaria de adultos jóvenes latinos (N = 83) del centro de Texas. Los participantes completaron una encuesta en línea sobre experiencias relacionadas con el COVID-19 y necesidades de salud mental. La encuesta incluyó preguntas sobre las experiencias personales y familiares del COVID-19 en dos áreas importantes: (a) tensión económica (por ejemplo, dificultades económicas, inseguridad alimentaria) y (b) carga psicosocial (por ejemplo, pérdida de relaciones, consumo de sustancias). Los análisis de regresión examinaron la asociación de las consecuencias del COVID-19 en el nivel de los síntomas de salud mental y los resultados clínicamente significativos. En comparación a las consecuencias económicas, las consecuencias psicosociales debido a la pandemia de COVID-19 se asociaron con niveles más altos de síntomas de salud mental. Por el contrario, en unos pocos casos, la tensión económica resultante de la pandemia se correlacionó con resultados clínicamente significativos en esta muestra. En conjunto, los hallazgos sugieren que los costos de la pandemia no solo se refieren a la mortalidad por enfermedad, sino también a la al deterioro de las circunstancias sociales y la salud mental. Los hallazgos de este estudio exigen atención inmediata para implementar políticas y programas que ayuden a mitigar las consecuencias económicas y socioemocionales del COVID-19, como el fácil acceso a recursos virtuales de salud mental de bajo costo para adultos jóvenes latinos.
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The purpose of this study was to analyze occupational and personal stressors, mental health indicators, perceived discrimination and help-seeking behaviors among healthcare workers and providers (HCWPs) serving socially vulnerable groups such as immigrants, refugees, farmworkers, homeless individuals, people living in poverty, and other disadvantaged populations in the United States (U.S.) during the COVID-19 pandemic. Using a cross-sectional descriptive approach, we gathered information between July and September 2020, from a sample of 407 affiliates of two national organizations of clinic-based HCWPs who worked at federally funded and community safety-net clinics. Informed consent was obtained from all participants who completed a self-administered online survey available in English and Spanish. Our results indicated that the HCWPs serving vulnerable groups in the midst of the pandemic experienced high levels of occupational and personal stressors as well as anxiety and depressive symptomology. Major occupational stressors were excessive workload, long working-hours, and institutional barriers to refer and follow-up on their clients' access to needed social services. High-rated personal stressors included sleep disorders, lack of and child-care, partner's loosing job, and other family related situations. Our findings suggest that HCWPs working with vulnerable populations need specialized interventions that bolster their mental health and well-being as the pandemic continues to unfold. We recommend implementing initiatives that encourage HCWPs' to be actively involved in clinic decisions regarding employee safety and protection as well as in management decisions to improve work place infrastructure and capacity to respond to the social needs of their clients. Lessons learned from the pandemic are useful tools in designing protocols for addressing the mental-health needs of HCWPs in health-care organizations that attend to socially underprivileged populations.
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COVID-19 , Estresse Ocupacional , Estudos Transversais , Pessoal de Saúde , Humanos , Saúde Mental , Estresse Ocupacional/epidemiologia , Pandemias , Discriminação Percebida , SARS-CoV-2 , Estados Unidos , Populações VulneráveisRESUMO
Objective: To investigate effects of school race/ethnic enrollment on mental health in early adolescence by examining both race/ethnic density (percent non-Latinx [NL] White enrollment) and diversity (range/size of all race/ethnic groups enrolled). Variation by student race/ethnic identity is examined as minority stressors are uniquely experienced by race/ethnic minority students. Design: Longitudinal cohort from a broader mental health study. Setting: Fourteen schools in Texas (2011-2015). Participants: Sixth-grade participants (mean age 11.5 years) linked to publicly available data about their school (N=389). Main Outcome Measures: Self-reported depressive-anxious symptoms over a two-year period. Methods: Generalized estimating equations tested main effects of density/diversity on depressive-anxious symptoms across student-reported race/ethnic identity, adjusting for student/school factors. Owing to statistically significant Latinx-group differences by acculturative stress, four unique identities were generated: NL-Black, low-stress Latinx, high-stress Latinx, and NL-White-referent. Points of convergence of student mental health profiles across density/diversity were explored. Results: A significant interaction between density and student race/ethnicity was found (P<.01), with NL-Black and low-stress Latinx vs NL-White students experiencing higher symptoms over the two-year period, net of covariates. In contrast, greater diversity was associated with higher symptoms, net of controls (P<.05). A marginally significant interaction (P=.06) revealed fewer symptoms for high-stress Latinx vs NL-White students. At about 25%, NL-White density and diversity of .5-.6, all students experienced similar mental health profiles. Conclusions: Greater NL-White density increases mental health risk for NL-Black and low-stress Latinx students, while school diversity lowers risk for high-stress Latinx students. These findings demonstrate how educational settings may produce or lessen minority stress.
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Etnicidade , Saúde Mental , Adolescente , Criança , Humanos , Grupos Minoritários , Fatores de Proteção , Instituições Acadêmicas , EstudantesRESUMO
School-based violence is a current public concern in the United States. One factor that can impact school-based violence that has gained much attention is mental health status. To better inform public perceptions, this study provides new evidence concerning the association between mental health status and acting out violence in school-aged populations. We examined a diverse sample of sixth graders across 14 schools in Texas in 2011-2012 (N = 721) who completed a self-administered survey assessing mental health symptoms and frequency of perpetration and/or receipt of different types of aggressive behaviors. Multinomial regression models tested whether adolescents with mental health symptoms (overall and by symptom types) are more predisposed to be actors only, recipients only, or both, of physical, verbal, and relational aggression. Across aggressive behavior types, symptomatic versus nonsymptomatic adolescents had consistently increased odds of being exclusively a recipient of aggression. When symptomatic adolescents did act out aggression, they participated concurrently as both an actor and recipient. Rarely were symptomatic adolescents more likely to be exclusively an actor of aggression. Moreover, symptomatic versus nonsymptomatic adolescents had five times the odds of being threatened by a weapon including a gun or knife. Compared to those who do not, youth who perceive having a mental health issue had twice the odds of being an actor only of verbal and relational aggression. These findings provide evidence for the need to change how the public associates mental health problems with aggressive behaviors among youth especially following national tragic events. Communities at large may benefit from evidence- and school-based interventions that improve awareness of and tolerance to mental health conditions among youth.
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Comportamento do Adolescente , Agressão , Adolescente , Criança , Humanos , Saúde Mental , Instituições Acadêmicas , Texas/epidemiologia , Estados Unidos , ViolênciaRESUMO
BACKGROUND: Addressing school violence is an important public health goal. To assess the role of school mental health curricula in violence prevention, we evaluated effects of an anti-stigma curriculum on violence victimization/perpetration. METHODS: An ethnically/socioeconomically diverse sample of 751 sixth-graders (mean age 11.5 years) across 14 schools in Texas were block-randomized by school (2011-2012) to receive singly or in combination: (1) a mental illness anti-stigma curriculum; (2) contact with 2 young adults with mental illness; or (3) merged control (printed materials/no intervention). Pre- and post-test assessments were self-completed during health education classes; prior to randomization, 484 (64.5%) agreed to 2-year, home-based longitudinal assessments. Statistical models tested short- and long-term effects on physical, verbal, and relational/social violence victimization/perpetration. RESULTS: At 1-month post-test, students who received the curriculum versus control made fewer verbal threats (p < .05). Those with high-level mental health symptoms in the curriculum group versus control used less violence overall and received fewer verbal threats from peers short-term (p < .05). Curriculum effects of reducing violence perpetration sustained long-term among adolescents with high-symptoms (p < .01). The comparator contact intervention was ineffective short- and long-term. CONCLUSIONS: Implementing efficacious mental health curricula can serve as a multi-pronged strategy with anti-bulling efforts to prevent violence and improve mental health.
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Vítimas de Crime , Saúde Mental , Adolescente , Criança , Currículo , Humanos , Instituições Acadêmicas , Violência/prevenção & controle , Adulto JovemRESUMO
OBJECTIVES: To determine the effectiveness of a school-based curriculum, Eliminating the Stigma of Differences (ESD), in improving attitudinal and/or behavioral contexts regarding mental illness in schools and increasing the likelihood that youth seek treatment for mental health problems when needed. METHODS: We conducted a cluster randomized trial in sixth-grade classes from 14 schools in 2011 and 2012 with follow-up at 6-month intervals through 24 months (2012-2015). Using a fully crossed 2 × 2 × 2 factorial design, we compared ESD to a no-intervention control and to 2 comparator interventions: (1) contact with 2 young adults with a history of mental illness and (2) exposure to antistigma printed materials. We implemented interventions in classrooms in an ethnically and socioeconomically diverse school district. There were 416 youth who participated in the follow-up, and 312 (75%) of these participated for the full 2 years. Outcome measures were knowledge and positive attitudes, social distance from peers with mental illness, and mental health treatment seeking. RESULTS: Youth assigned to ESD reported greater knowledge and positive attitudes and reduced social distance (Cohen's d = 0.35 and 0.16, respectively) than youth in the comparator interventions and no-intervention groups across the 2-year follow-up. Youth with high levels of mental health symptoms were more likely (odds ratio = 3.51; confidence interval = 1.08-11.31) to seek treatment during follow-up if assigned to ESD than if they were assigned to comparator interventions or no intervention. CONCLUSIONS: ESD shows potential for improving the social climate related to mental illnesses in schools and increasing treatment seeking when needed. ESD and interventions like it show promise as part of a public mental health response to youth with mental health needs in schools.
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Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Serviços de Saúde Escolar , Instituições Acadêmicas , Estigma Social , Adulto , Criança , Análise por Conglomerados , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/terapiaRESUMO
PURPOSE: Media-a powerful influence on mental illness stigma-varies by language and culture. Nevertheless, recent meta-analyses have demonstrated scant attention to Spanish language media as well as historically low Latinx participation in mental illness anti-stigma intervention. To better inform how to improve equity in mental health service utilization, this study assessed how language preferences in mass media influence stigma among Latinx adolescents, compared to family language and social preferences. METHODS: Sixth-graders self-identifying as Latinx self-completed assessments of mental illness knowledge/positive attitudes and desired separation from peers and adolescent vignette characters experiencing mental illness (N = 179; Texas, U.S., 2011-2012). Participants also responded to measures of language preferences (any Spanish versus only English) for consuming media (film/television, music/radio) and speaking with family (parents/grandparents), and social preferences for parties or social gatherings (Latinx versus Anglo persons). Linear regression models adjusting for student and household factors examined the associations between media and family language and social preferences on mental illness stigma. RESULTS: Latinx adolescents preferring any Spanish versus English-only media reported less mental illness knowledge/positive attitudes and greater social separation from peers and vignette characters with a mental illness, net of all covariates. Family language and social preferences were not associated with any mental illness stigma outcomes. CONCLUSIONS: Spanish media preference is associated with greater stigma suggesting more stigmatization may exist in Spanish- versus English-media. Ensuring anti-stigma messaging in Spanish media may reduce disparities in mental illness stigma among Latinx adolescents. These findings have implications for populations with other non-English media preferences.
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Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispânico ou Latino/psicologia , Transtornos Mentais/psicologia , Estigma Social , Estereotipagem , Adolescente , Comportamento do Consumidor , Feminino , Humanos , Idioma , Masculino , Meios de Comunicação de Massa , Transtornos Mentais/etnologia , Texas , Adulto JovemRESUMO
Differences in mental illness (MI) stigma among adolescents were examined cross-sectionally across race, ethnicity, and gender to identify target populations and cultural considerations for future antistigma efforts. An ethnically and socioeconomically diverse sample of sixth graders (N = 667; mean age = 11.5) self-completed assessments of their MI-related knowledge, positive attitudes, and behaviors toward peers with MI and adolescent vignettes described as experiencing bipolar (Julia) and social anxiety (David) symptoms. Self-reported race, ethnicity, and gender were combined to generate 6 intersectional composite variables: Latino boys, Latina girls, non-Latina/o (NL) Black boys, NL-Black girls, NL-White boys, and NL-White girls-referent. Linear regression models adjusting for personal and family factors examined differences in stigma using separate and composite race, ethnicity, and gender variables. In main effects models, boys and Latina/o adolescents reported greater stigma for some outcomes than girls and NL-White adolescents, respectively. However, intersectional analyses revealed unique patterns. NL-Black boys reported less knowledge/positive attitudes than NL-Black and White girls. NL-Black and Latino boys reported greater avoidance/discomfort than NL-White girls. Moreover, NL-Black girls and boys and Latina/o girls and boys wanted more social separation from peers with mental illness than NL-White girls; NL-Black boys also reported more separation than NL-White boys, NL-Black girls, and Latina girls. Finally, NL-Black boys and Latina girls wanted more distance from David than NL-White and Black girls. Vital for informing future antistigma interventions, this study generates new knowledge about how differences in views about MI exist across racial and ethnic identity, and how gender intersects with these perceptions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Negro ou Afro-Americano/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispânico ou Latino , Transtornos Mentais , Pessoas Mentalmente Doentes , Estigma Social , População Branca/etnologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
INTRODUCTION: This systematic literature review provides evidence concerning the association of school race/ethnic composition in mental health outcomes among adolescents (ages 11-17 years). A range of mental health outcomes were assessed (e.g., internalizing behaviors, psychotic symptoms) in order to broadly capture the relationship between school context on mental health and psychological wellbeing. METHODS: A search across six databases from 1990 to 2018 resulted in 13 articles from three countries (United States, United Kingdom, and the Netherlands) that met inclusion criteria following a two step review of titles/abstracts and full-text. RESULTS: The existing research on school race/ethnic composition and mental health point to two distinct measures of school composition: density-the proportion of one race/ethnic group enrolled in a school, and diversity-an index capturing the range and size of all race/ethnic groups enrolled in a school. Overall, higher same race/ethnic peer density was associated with better mental health for all adolescents. In contrast, there was no overall strong evidence of mental health advantage in schools with increased diversity. CONCLUSIONS: Theoretical and methodological considerations for future research towards strengthening causal inference, and implications for policies and practices concerning the mental health of adolescent-aged students are discussed.
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Diversidade Cultural , Saúde Mental , Instituições Acadêmicas/organização & administração , Estudantes/psicologia , Adolescente , Criança , Feminino , Humanos , Psicologia do AdolescenteRESUMO
There is increasing evidence that depression may affect diet. However, little is known about the association between depression and diet quality among foreign-born Latinas. We hypothesized that depressive symptoms would be associated with poorer diet quality in foreign-born Latinas. Furthermore, we believed that physical activity (PA) would have a protective effect on diet quality for individuals experiencing depressive symptoms. Our study evaluated the diet (Healthy Eating Index) and PA (Actigraph GT3X activity monitors) of 534 foreign-born Latinas with and without depressive symptoms (Center for Epidemiological Studies Depression Scale). A series of logistic regression models were estimated to examine our hypotheses. As predicted, Latinas who were depressed had significantly lower odds of having a high-quality diet than non-depressed Latinas. Unexpectedly, among Latinas who met PA guidelines, depressed Latinas had a significantly lower probability of having higher-quality diets than their non-depressed counterparts. Our findings support current research stating that depressive symptoms are associated with lower Healthy Eating Index scores. More research is necessary to elucidate the relationship between PA and dietary quality of depressed Latinas. Innovative approaches to address mental health and the stressors that can compound its severity are needed to improve diet quality among foreign-born Latina women.
Assuntos
Depressão , Dieta/normas , Exercício Físico , Hispânico ou Latino , Adulto , Feminino , Humanos , Modelos Logísticos , México , Pessoa de Meia-Idade , Modelos Biológicos , Características de Residência , Estados UnidosRESUMO
Based on the premise that treatment changes people in ways that are consequential for subsequent treatment-seeking, we question the validity of an unrecognized and apparently inadvertent assumption in mental health services research conducted within a psychiatric epidemiology paradigm. This homogeneity assumption statistically constrains the effects of potential determinants of recent treatment to be identical for former patients and previously untreated persons by omitting treatment history or modeling only main effects. We test this assumption with data from the 2001-2003 Collaborative Psychiatric Epidemiology Surveys; the weighted pooled sample is representative of noninstitutionalized U.S. adults (18+; analytic n = 19,227). Contrary to the homogeneity assumption, some associations with recent treatment are conditional on past treatment, including psychiatric disorder and race-ethnicity-measures of need and treatment disparities, respectively. We conclude that the widespread application of the homogeneity assumption probably masks differences in the determinants of recent use between previously untreated persons and former patients.