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Mental Health Stigma and Self-Concealment as Predictors of Help-Seeking Attitudes among Latina/o College Students in the United States

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Abstract

The study examined whether mental health stigma and self-concealment are uniquely related to various dimensions of attitudes toward seeking professional psychological services (i.e., help-seeking attitudes) in Latina/o college students. Data from 129 Latina/o undergraduates (76 % female) were used in the analysis. Results revealed that mental health stigma was a unique predictor of overall help-seeking attitudes. Mental health stigma was also significantly related to recognition of need for psychotherapeutic help, stigma tolerance, and interpersonal openness, but not to confidence in mental health practitioners. Self-concealment was uniquely related to stigma tolerance and interpersonal openness.

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Notes

  1. “Latinos” will be used as the generic term throughout the paper when referring to people of Latin American extraction or descent. When the matter relates to specific gender groups, Latinas (women) and Latinos (men) will be the terms used.

References

  • Abdullah, T., & Brown, T. L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: an integrative review. Clinical Psychology Review, 31(6), 934–948. doi:10.1016/j.cpr.2011.05.003.

    Article  PubMed  Google Scholar 

  • Ajzen, I. (1985). From intentions to actions: a theory of planned behavior. In J. Kuhl & J. Beckmann (Eds.), Action control: from cognition to behavior (pp. 11–39). Heidelberg: Springer.

    Chapter  Google Scholar 

  • Ajzen, I. (2012). The theory of planned behavior. In P. M. Van Lange, A. W. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology (Vol. 1, pp. 438–459). Thousand Oaks: Sage Publications Ltd.

    Chapter  Google Scholar 

  • Alegría, M., Canino, G., Shrout, P. E., Woo, M., Duan, N., Vila, D., & Meng, X.-L. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry, 165, 359–369. doi:10.1176/appi.ajp.2007.07040704.

    Article  PubMed Central  PubMed  Google Scholar 

  • Atkinson, D. R., & Gim, R. H. (1989). Asian-American cultural identity and attitudes toward mental health services. Journal of Counseling Psychology, 36(2), 209–212. doi:10.1037/0022-0167.36.2.209.

    Article  Google Scholar 

  • Bermúdez, J. M., Kirkpatrick, D. R., Hecker, L., & Torres-Robles, C. (2010). Describing Latinos families and their help-seeking attitudes: challenging the family therapy literature. Contemporary Family Therapy: An International Journal, 32(2), 155–172. doi:10.1007/s10591-009-9110-x.

    Article  Google Scholar 

  • Blanco, C., Patel, S. R., Liu, L., Jiang, H., Lewis-Fernández, R., Schmidt, A. B., & Olfson, M. (2007). National trends in ethnic disparities in mental health care. Medical Care, 45(11), 1012–1019. doi:10.1097/MLR.0b013e3180ca95d3.

    Article  PubMed  Google Scholar 

  • Brennan, M., Vega, M., Garcia, I., Abad, A., & Friedman, M. B. (2005). Meeting the mental health needs of elderly Latinos affected by depression: implications for outreach and service provision. Care Management Journals, 6(2), 98–106. doi:10.1891/cmaj.6.2.98.

    Article  PubMed  Google Scholar 

  • Breslau, J., Aguilar-Gaxiola, S., Kendler, K. S., Su, M., Williams, D., & Kessler, R. C. (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine, 36(1), 57–68. doi:10.1017/s0033291705006161.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bridges, A. J., Andrews, A. R., III, & Deen, T. L. (2012). Mental health needs and service utilization by Hispanic immigrants residing in mid-southern United States. Journal of Transcultural Nursing, 23, 359–368. doi:10.1177/1043659612451259.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cabassa, L. J. (2013). Community mental health services to Latinos. In J. Rosenberg & S. J. Rosenberg (Eds.), Community mental health: challenges for the 21st century (2nd ed., pp. 162–178). New York: Routledge/Taylor & Francis Group.

    Google Scholar 

  • Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health care: a review of epidemiological studies. Administration and Policy in Mental Health and Mental Health Services Research, 33, 316–330. doi:10.1007/s10488-006-0040-8.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cardemil, E. V., & Sarmiento, I. A. (2009). Clinical approaches to working with Latino adults. In F. A. Villarruel, G. Carlo, J. M. Grau, M. Azmitia, N. J. Cabrera, & T. J. Chahin (Eds.), Handbook of U.S. Latino psychology: developmental and community-based perspectives (pp. 329–345). Thousand Oaks: Sage Publications, Inc.

    Google Scholar 

  • Cepeda-Benito, A., & Short, P. (1998). Self-concealment, avoidance of psychological services, and perceived likelihood of seeking professional help. Journal of Counseling Psychology, 45(1), 58–64. doi:10.1037/0022-0167.45.1.58.

    Article  Google Scholar 

  • Chang, J., Natsuaki, M. N., & Chen, C.-N. (2013). The importance of family factors and generation status: mental health service use among Latino and Asian Americans. Cultural Diversity and Ethnic Minority Psychology, 19(3), 236–247. doi:10.1037/a0032901.

    Article  PubMed  Google Scholar 

  • Cheng, H.-L., Kwan, K.-L. K., & Sevig, T. (2013). Racial and ethnic minority college students’ stigma associated with seeking psychological help: examining psychocultural correlates. Journal of Counseling Psychology, 60(1), 98–111. doi:10.1037/a0031169.

    Article  PubMed  Google Scholar 

  • Chiang, L., Hunter, C. D., & Yeh, C. J. (2004). Coping attitudes, sources, and practices among black and Latino college students. Adolescence, 39(156), 793–815.

    PubMed  Google Scholar 

  • Comas-Diaz, L. (2006). Latino healing: the integration of ethnic psychology into psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 43(4), 436–453. doi:10.1037/0033-3204.43.4.436.

    Article  Google Scholar 

  • Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614–625. doi:10.1037/0003-066x.59.7.614.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765–776. doi:10.1037/0003-066x.54.9.765.

    Article  PubMed  Google Scholar 

  • Cramer, K. M. (1999). Psychological antecedents to help-seeking behavior: a reanalysis using path modeling structures. Journal of Counseling Psychology, 46(3), 381–387. doi:10.1037/0022-0167.46.3.381.

    Article  Google Scholar 

  • Falicov, C.J. (2009). Religion and spiritual traditions in immigrant families: significance for Latino health and mental health. In F. Walsh (Ed.), Spiritual resources in family therapy (pp. 156–173).

  • Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychologial help: a shortened form and considerations for research. Journal of College Student Development, 36(4), 368–373.

    Google Scholar 

  • Fischer, E. H., & Turner, J. I. (1970). Orientations to seeking professional help: development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35(1, Pt.1), 79–90. doi:10.1037/h0029636.

    Article  PubMed  Google Scholar 

  • Gloria, A. M., Castellanos, J., Segura-Herrera, T. A., & Mayorga, M. (2010). Assessing cultural orientation, cultural fit, and help-seeking attitudes of Latina undergraduates. Journal of College Counseling, 13(2), 126–140. doi:10.1002/j.2161-1882.2010.tb00054.x.

    Article  Google Scholar 

  • Gonzalez, J. M., Alegria, M., & Prihoda, T. J. (2005). How do attitudes toward mental health treatment vary by age, gender, and ethnicity/race in young adults? Journal of Community Psychology, 33(5), 611–629. doi:10.1002/jcop.20071.

    Article  Google Scholar 

  • Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P., & Anderson, K. (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic Whites in the United States: results from the National Epidemiologic Survey on alcohol and related conditions. Archives of General Psychiatry, 61, 1226–1233. doi:10.1001/archpsyc.61.12.1226.

    Article  PubMed  Google Scholar 

  • Hayes, S. C., Niccolls, R., Masuda, A., & Rye, A. K. (2002). Prejudice, terrorism and behavior therapy. Cognitive and Behavioral Practice, 9(4), 296–301. doi:10.1016/s1077-7229(02)80023-2.

    Article  Google Scholar 

  • Humes, K. R., Jones, N. A., & Ramirez, R. (2011). Overview of race and Hispanic origin: 2010 (C2010BR-02). Washington: U.S. Census Bureau. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf.

    Google Scholar 

  • Interian, A., Martinez, I. E., Guarnaccia, P. J., Vega, W. A., & Escobar, J. I. (2007). A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatric Services, 58(12), 1591–1594. doi:10.1176/appi.ps.58.12.1591.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jorm, A. F., Medway, J., Christensen, H., Korten, A. E., Jacomb, P. A., & Rodgers, B. (2000). Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry, 34(4), 619–626. doi:10.1046/j.1440-1614.2000.00761.x.

    Article  PubMed  Google Scholar 

  • Kearney, L. K., Draper, M., & Barón, A. (2005). Counseling utilization by ethnic minority college students. Cultural Diversity and Ethnic Minority Psychology, 11(3), 272–285. doi:10.1037/1099-9809.11.3.272.

    Article  PubMed  Google Scholar 

  • Kelly, A. E., & Achter, J. A. (1995). Self-concealment and attitudes toward counseling in university students. Journal of Counseling Psychology, 42(1), 40–46. doi:10.1037/0022-0167.42.1.40.

    Article  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. doi:10.1001/archpsyc.62.6.617.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kouyoumdjian, H., Zamboanga, B. L., & Hansen, D. J. (2003). Barriers to community mental health services for Latinos: treatment considerations. Clinical Psychology: Science and Practice, 10(4), 394–422. doi:10.1093/clipsy/bpg041.

    Google Scholar 

  • Larson, D. G., & Chastain, R. L. (1990). Self-concealment: conceptualization, measurement, and health implications. Journal of Social and Clinical Psychology, 9(4), 439–455.

    Article  Google Scholar 

  • Leaf, P. J., & Bruce, M. L. (1987). Gender differences in the use of mental health-related services: a re-examination. Journal of Health and Social Behavior, 28(2), 171–183. doi:10.2307/2137130.

    Article  PubMed  Google Scholar 

  • Leong, F. T. L., & Zachar, P. (1999). Gender and opinions about mental illness as predictors of attitudes toward seeking professional psychological help. British Journal of Guidance and Counselling, 27(1), 123–132. doi:10.1080/03069889900760101.

    Article  Google Scholar 

  • Leong, F. T. L., Wagner, N. S., & Tata, S. P. (1995). Racial and ethnic variations in help-seeking attitudes. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander (Eds.), Handbook of multicultural counseling (pp. 415–438). Thousand Oaks: Sage Publications, Inc.

    Google Scholar 

  • Liao, H.-Y., Rounds, J., & Klein, A. G. (2005). A test of Cramer’s (1999) help-seeking model and acculturation effects with Asian and Asian American college students. Journal of Counseling Psychology, 52(3), 400–411. doi:10.1037/0022-0167.52.3.400.

    Article  Google Scholar 

  • López, S. R. (1997). Cultural competence in psychotherapy: a guide for clinicians and their supervisors. In C. E. Watkins Jr. (Ed.), Handbook of psychotherapy supervision (pp. 570–588). Hoboken: Wiley.

    Google Scholar 

  • López, S. R. (2002). Mental health care for Latinos: a research agenda to improve the accessibility and quality of mental health care for Latinos. Psychiatric Services, 53(12), 1569–1573. doi:10.1176/appi.ps.53.12.1569.

    Article  PubMed  Google Scholar 

  • López, S. R., Mdel Lara, M. C., Kopelowicz, A., Solano, S., Foncerrada, H., & Aguilera, A. (2009). La CLAve to increase psychosis literacy of Spanish-speaking community residents and family caregivers. Journal of Consulting and Clinical Psychology, 77(4), 763–774. doi:10.1037/a0016031.

    Article  PubMed Central  PubMed  Google Scholar 

  • López, S. R., Barrio, C., Kopelowicz, A., & Vega, W. A. (2012). From documenting to eliminating disparities in mental health care for Latinos. American Psychologist, 67(7), 511–523. doi:10.1037/a0029737.

    Article  PubMed  Google Scholar 

  • Marquez, J. A., & Ramírez García, J. I. (2013). Family caregivers’ narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness. Journal of Family Psychology, 27(3), 398–408. doi:10.1037/a0032868.

    Article  PubMed  Google Scholar 

  • Masuda, A., & Boone, M. S. (2011). Mental health stigma, self-concealment, and help-seeking attitudes among Asian American and European American college students with no help-seeking experience. International Journal for the Advancement of Counselling, 33(4), 266–279. doi:10.1007/s10447-011-9129-1.

    Article  Google Scholar 

  • Masuda, A., & Latzman, R. D. (2011). Examining associations among factor-analytically derived components of mental health stigma, distress, and psychological flexibility. Personality and Individual Differences, 51(4), 435–438. doi:10.1016/j.paid.2011.04.008.

    Article  Google Scholar 

  • Masuda, A., Suzumura, K., Beauchamp, K. L., Howells, G. N., & Clay, C. (2005). United States and Japanese college students’ attitudes toward seeking professional psychological help. International Journal of Psychology, 40(5), 303–313. doi:10.1080/00207590444000339.

    Article  Google Scholar 

  • Masuda, A., Hayes, S. C., Fletcher, L. B., Seignourel, P. J., Bunting, K., Herbst, S. A., & Lillis, J. (2007). Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders. Behaviour Research and Therapy, 45(11), 2764–2772. doi:10.1016/j.brat.2007.05.008.

    Article  PubMed  Google Scholar 

  • Masuda, A., Anderson, P. L., Twohig, M. P., Feinstein, A. B., Chou, Y.-Y., Wendell, J. W., & Stormo, A. R. (2009a). Help-seeking experiences and attitudes among African American, Asian American, and European American college students. International Journal for the Advancement of Counselling, 31(3), 168–180. doi:10.1007/s10447-009-9076-2.

    Article  Google Scholar 

  • Masuda, A., Hayes, S. C., Lillis, J., Bunting, K., Herbst, S. A., & Fletcher, L. B. (2009b). The relation between psychological flexibility and mental health stigma in acceptance and commitment therapy: a preliminary process investigation. Behavior and Social Issues, 18(1), 1–16.

    Article  Google Scholar 

  • Masuda, A., Hayes, S. C., Twohig, M. P., Lillis, J., Fletcher, L. B., & Gloster, A. T. (2009c). Comparing Japanese international college students’ and U.S. college students’ mental-health-related stigmatizing attitudes. Journal of Multicultural Counseling and Development, 37(3), 178–189. doi:10.1002/j.2161-1912.2009.tb00101.x.

    Article  Google Scholar 

  • Masuda, A., Price, M., Anderson, P. L., Schmertz, S. K., & Calamaras, M. R. (2009d). The role of psychological flexibility in mental health stigma and psychological distress for the stigmatizer. Journal of Social and Clinical Psychology, 28(10), 1244–1262. doi:10.1521/jscp.2009.28.10.1244.

    Article  Google Scholar 

  • Masuda, A., Anderson, P. L., & Edmonds, J. (2012). Help-seeking attitudes, mental health stigma, and self-concealment among African American college students. Journal of Black Studies, 43(7), 773–786. doi:10.1177/0021934712445806.

    Article  Google Scholar 

  • Meissen, G., Warren, M. L., & Kendall, M. (1996). An assessment of college student willingness to use self-help groups. Journal of College Student Development, 37(4), 448–456.

    Google Scholar 

  • Miville, M. L., & Constantine, M. G. (2006). Sociocultural predictors of psychological help-seeking attitudes and behavior among Mexican American college students. Cultural Diversity and Ethnic Minority Psychology, 12(3), 420–432. doi:10.1037/1099-9809.12.3.420.

    Article  PubMed  Google Scholar 

  • Nam, S. K., Chu, H. J., Lee, M. K., Lee, J. H., Kim, N., & Lee, S. M. (2010). A meta-analysis of gender differences in attitudes toward seeking professional psychological help. Journal of American College Health, 59(2), 110–116. doi:10.1080/07448481.2010.483714.

    Article  PubMed  Google Scholar 

  • Nam, S. K., Choi, S. I., Lee, J. H., Lee, M. K., Kim, A. R., & Lee, S. M. (2013). Psychological factors in college students’ attitudes toward seeking professional psychological help: a meta-analysis. Professional Psychology: Research and Practice, 44(1), 37–45. doi:10.1037/a0029562.

    Article  Google Scholar 

  • Olfson, M., Moitabai, R., Sampson, N. A., Hwang, I., & Kessler, R. C. (2009). Dropout from outpatient mental health care in the United States. Psychiatric Services, 60, 898–907. doi:10.1176/appi.ps.60.7.898.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pattyn, E., Verhaeghe, M., Sercu, C., & Bracke, P. (2014). Public stigma and self-stigma: differential association with attitudes toward formal and informal help seeking. Psychiatric Services, 65(2), 232–238.

    Article  PubMed  Google Scholar 

  • Ramos-Sánchez, L., & Atkinson, D. R. (2009). The relationships between Mexican American acculturation, cultural values, gender, and help-seeking intentions. Journal of Counseling and Development, 87(1), 62–71. doi:10.1002/j.1556-6678.2009.tb00550.x.

    Article  Google Scholar 

  • Rastogi, M., Massey-Hastings, N., & Wieling, E. (2012). Barriers to seeking mental health services in the Latino/a community: a qualitative analysis. Journal of Systemic Therapies, 31(4), 1–17. doi:10.1521/jsyt.2012.31.4.1.

    Article  Google Scholar 

  • Rojas-Vilches, A. P., Negy, C., & Reig-Ferrer, A. (2011). Attitudes toward seeking therapy among Puerto Rican and Cuban American young adults and their parents. International Journal of Clinical and Health Psychology, 11(2), 313–341.

    Google Scholar 

  • Sanchez, A. R., & Atkinson, D. R. (1983). Mexican-American cultural commitment, preference for counselor ethnicity, and willingness to use counseling. Journal of Counseling Psychology, 30(2), 215–220. doi:10.1037/0022-0167.30.2.215.

    Article  Google Scholar 

  • Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: confronting racial and ethnic disparities in health care. Washington: National Academies Press.

    Google Scholar 

  • U. S. Department of Health and Human Services. (2001). Mental health: culture, race, and ethnicity - a supplement to mental health: a report of the surgeon general.

  • U. S. Department of Health Human Services. (1999). A Report of the surgeon general.

  • Vega, W. A., Karno, M., Alegria, M., Alvidrez, J., Bernal, G., Escamilla, M., & Loue, S. (2007). Research issues for improving treatment of U.S. Hispanics with persistent mental disorders. Psychiatric Services, 58(3), 385–394. doi:10.1176/appi.ps.58.3.385.

    Article  PubMed  Google Scholar 

  • Vogel, D. L., Wester, S. R., Wei, M., & Boysen, G. A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. Journal of Counseling Psychology, 52(4), 459–470. doi:10.1037/0022-0167.52.4.459.

    Article  Google Scholar 

  • Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling: psychological factors that inhibit seeking help. Journal of Counseling and Development, 85(4), 410–422. doi:10.1002/j.1556-6678.2007.tb00609.x.

    Article  Google Scholar 

  • Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 629–640. doi:10.1001/archpsyc.62.6.629.

    Article  PubMed  Google Scholar 

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Mendoza, H., Masuda, A. & Swartout, K.M. Mental Health Stigma and Self-Concealment as Predictors of Help-Seeking Attitudes among Latina/o College Students in the United States. Int J Adv Counselling 37, 207–222 (2015). https://doi.org/10.1007/s10447-015-9237-4

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