A Review of Mental Health and Mental Health Care Disparities Research: 2011-2014.

Racial/ethnic minorities in the United States are more likely than Whites to have severe and persistent mental disorders and less likely to access mental health care. This comprehensive review evaluates studies of mental health and mental health care disparities funded by the National Institute of Mental Health (NIMH) to provide a benchmark for the 2015 NIMH revised strategic plan. A total of 615 articles were categorized into five pathways underlying mental health care and three pathways underlying mental health disparities. Identified studies demonstrate that socioeconomic mechanisms and demographic moderators of disparities in mental health status and treatment are well described, as are treatment options that support diverse patient needs. In contrast, there is a need for studies that focus on community- and policy-level predictors of mental health care disparities, link discrimination- and trauma-induced neurobiological pathways to disparities in mental illness, assess the cost effectiveness of disparities reduction programs, and scale up culturally adapted interventions.

An association between multiculturalism and psychological distress.

Amidst increasing focus on rising rates of substance abuse and suicide among white Americans and extending prior research on intergroup attitudes and health, this study examines a novel factor associated with psychological distress: disagreement with multiculturalism. Using the Portraits of American Life Study (N = 2,292), logistic regressions indicate that for Whites and Hispanics, increased likelihood of psychological distress (depression, hopelessness and worthlessness) is associated with stronger disagreement with multiculturalism, measured as "If we want to create a society where people get along, we must recognize that each ethnic group has the right to maintain its own unique traditions." For Blacks, however, attitudes toward multiculturalism are not associated with psychological distress. Future research might determine if these results can be replicated, and if so, identify the causal mechanism(s) at work.

Immigration concern and the white/non-white difference in smoking: Group position theory and health.

National data indicate that U.S. whites have a higher prevalence of smoking compared to non-whites. Group position theory and public opinion data suggest racial differences in immigration concern. This study examines whether immigration concern mediates the racial difference in smoking. Drawing on the 2012 General Social Survey, the 2012 American National Election Study, and the 2006 Portraits of American Life Study, immigration concern was associated with smoking, controlling for covariates across all three nationally representative surveys. Mediation analysis indicated that immigration concern partially mediated the higher odds of smoking among whites across all surveys. Immigration concern also presents a possible explanation for the healthy immigrant advantage and Hispanic paradox as they pertain to smoking differences.

Support for immigration reduction and physician distrust in the United States.

OBJECTIVES: Health research indicates that physician trust in the United States has declined over the last 50 years. Paralleling this trend is a decline in social capital, with researchers finding a negative relationship between immigration-based diversity and social capital. This article examines whether physician distrust is also tied to immigration-based diversity and declining social capital. METHODS: Data come from the 2012 General Social Survey, one of the gold standards of US public opinion surveys, using a national probability sample of 1080 adult US respondents. Key measures included support for reducing levels of immigration to the United States and multiple measures of physician trust. RESULTS: The results of ordinary least squares regressions, using survey weights, indicate that support for reducing immigration is positively linked to physician distrust, bringing physician distrust into the orbit of research on diversity and declining social capital. Models controlled for age, education, income, gender, race, nativity, conservatism, unemployed status, lack of health insurance, and self-rated health. Furthermore, analyses of a subset of respondents reveal that measures of general trust and some forms of institutional trust do not explain away the association between support for immigration reduction and physician distrust, though confidence in science as an institution appears relevant. CONCLUSION: Consistent with diversity and social capital research, this article finds that an immigration attitude predicts physician distrust. Physician distrust may not be linked just to physician-patient interactions, the structure of the health care system, or health policies, but could also be tied to declining social trust in general.

Racial resentment and smoking.

Racial resentment (also known as symbolic racism) is among the most widely tested measures of contemporary prejudice in political science and social psychological research over the past thirty years. Proponents argue that racial resentment reflects anti-black emotion obtained through pre-adult socialization. In light of affect-based models of substance use, this paper examined the association between racial resentment and smoking in a national sample of non-Hispanic white, black, and Hispanic respondents. Data come from the 2012 American National Election Study, which contained two measures of smoking. The results of ordinal logistic regression models indicate a positive association between racial resentment and smoking among non-Hispanic whites (N = 2133) that is not present among blacks (N = 693) or Hispanics (N = 660). Models controlled for age, education, income, gender, political ideology, region, and mode of interview. Furthermore, analyses indicated that a measure of race-related affect, admiration and sympathy towards blacks, partially mediated the association between racial resentment and smoking. For non-Hispanic whites, racial resentment appears to constitute a risk factor for smoking. Future studies should further specify the conditions linking substance use to the race-related affective component of racial resentment.

Rhesus macaque model of chronic opiate dependence and neuro-AIDS: longitudinal assessment of auditory brainstem responses and visual evoked potentials.

Our work characterizes the effects of opiate (morphine) dependence on auditory brainstem and visual evoked responses in a rhesus macaque model of neuro-AIDS utilizing a chronic continuous drug delivery paradigm. The goal of this study was to clarify whether morphine is protective, or if it exacerbates simian immunodeficiency virus (SIV)-related systemic and neurological disease. Our model employs a macrophage tropic CD4/CCR5 coreceptor virus, SIV(mac)239 (R71/E17), which crosses the blood-brain barrier shortly after inoculation and closely mimics the natural disease course of human immunodeficiency virus infection. The cohort was divided into three groups: morphine only, SIV only, and SIV + morphine. Evoked potential (EP) abnormalities in subclinically infected macaques were evident as early as 8 weeks postinoculation. Prolongations in EP latencies were observed in SIV-infected macaques across all modalities. Animals with the highest cerebrospinal fluid viral loads and clinical disease showed more abnormalities than those with subclinical disease, confirming our previous work (Raymond et al., J Neurovirol 4:512-520, 1998; J Neurovirol 5:217-231, 1999; AIDS Res Hum Retroviruses 16:1163-1173, 2000). Although some differences were observed in auditory and visual evoked potentials in morphine-treated compared to morphine-untreated SIV-infected animals, the effects were relatively small and not consistent across evoked potential type. However, morphine-treated animals with subclinical disease had a clear tendency toward higher virus loads in peripheral and central nervous system tissues (Marcario et al., J Neuroimmune Pharmacol 3:12-25, 2008) suggesting that if had been possible to follow all animals to end-stage disease, a clearer pattern of evoked potential abnormality might have emerged.

Spectral shape sensitivity contributes to the azimuth tuning of neurons in the cat's inferior colliculus.

We recorded high-best-frequency single-unit responses to free-field noise bursts that varied in intensity and azimuth to determine whether inferior colliculus (IC) neurons derive directionality from monaural spectral-shape. Sixty-nine percent of the sample was directional (much more responsive at some azimuths than others). One hundred twenty-nine directional units were recorded under monaural conditions (unilateral ear plugging). Binaural directional (BD) cells showed weak monaural directionality. Monaural directional (MD) cells showed strong monaural directionality, i.e., were much more responsive at some directions than others. Some MD cells were sensitive to both monaural and binaural directional cues. MD cells were monaurally nondirectional in response to tone bursts that lack direction-dependent variation in spectral shape. MD cells were unresponsive to noise bursts at certain azimuths even at high intensities showing that particular spectral shapes inhibit their responses. Two-tone inhibition was stronger where MD cells were unresponsive to noise stimulation than at directions where they were responsive. According to the side-band inhibition model, MD cells derive monaural directionality by comparing energy in excitatory and inhibitory frequency domains and thus should have stronger inhibitory side-bands than BD cells. MD and BD cells showed differences in breadth of excitatory frequency domains, strength of nonmonotonic level tuning, and responsiveness to tones and noise that were consistent with this prediction. Comparison of these data with previous findings shows that strength of spectral inhibition increases greatly between the level of the cochlear nucleus and the IC, and there is relatively little change in strength of spectral inhibition among the IC, auditory thalamus, and cortex.