Self‐Stigma,Mental Health Literacy,and Attitudes Toward Seeking Psychological Help

This study examined self‐stigma of seeking psychological help and mental health literacy as predictors of college students’ (N = 1,535) help‐seeking attitudes, with additional attention to psychological and demographic correlates. Results indicated that mental health literacy predicted help‐seeking attitudes above and beyond self‐stigma. Asian American race/ethnicity, male gender, current psychological distress, and help‐seeking history were also significant predictors. Implications for addressing mental health literacy and self‐stigma while attending to demographic and psychological variations in help seeking are discussed.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Minority stress and health: Implications for lesbian,gay, bisexual,transgender, and questioning (LGBTQ) young people

Historically, the pathologization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) orientations shaped research and professional practice, while the impact of stigma was not considered. Within a minority stress conceptualization however, stigma-related prejudice and discrimination experienced by LGBTQ people constitute chronically stressful events that can lead to negative health outcomes. Minority stress has been linked to psychological distress among gay men and lesbians and may contribute to elevated rates of distress frequently observed among LGBTQ youth. This study explored the impact of minority stress on psychological distress among LGBTQ youth in Ireland. Measures assessing three components of minority stress (sexual identity distress, stigma consciousness, and heterosexist experiences) were administered online to LGBTQ youth aged 16–24 years (N = 301). Each minority stressor had a significant independent association with distress. Stepwise regression analyses identified the linear combination of minority stressors as significantly predictive of distress [F(3,201) = 30.80, p ≤ 0.001]. Results suggest that the oppressive social environment created through sexual/transgender identity-related stigma negatively impacts on the well-being of LGBTQ youth. These findings have implications for health professionals and policy makers interested in the concerns of LGBTQ youth experiencing difficulties related to minority status and will facilitate the development and tailoring of interventions aimed at reaching those most at risk.     

Relationships between mindfulness, self-control, and psychological functioning

The purpose of this study was to investigate whether dispositional mindfulness (the tendency to be mindful in general daily life) accounts for variance in psychological symptoms and wellbeing after accounting for the influence of dispositional self-control (the tendency to be self-disciplined, reliable, hardworking, etc.). A large sample of undergraduate students (N = 280) completed self-report measures of mindfulness, self control, psychological wellbeing, and general psychological distress (depression and anxiety, and stress). As expected, both mindfulness and self-control were positively correlated with wellbeing and negatively correlated with general distress. Mindfulness was found to account for significant variance in psychological wellbeing and general distress after accounting for self-control. In addition, mindfulness was a significant moderator of the relationship between self-control and psychological symptoms. Results show that although self-control predicts significant variance in psychological health, mindfulness predicts incremental variance, suggesting that a mindful approach to ongoing experience can contribute to mental health in persons who are highly self-disciplined and hardworking.     

Sleep,resilience, and psychological distress in United States military Veterans

Sleep problems are prevalent among Veterans. Left untreated, such problems may elevate psychological distress and increase risk of subsequent mental health disorders. Psychological resilience may buffer against negative psychological outcomes, yet the relationship between sleep and resilience has not been studied. This study explored poor sleep, resilience, and psychological distress using questionnaires collected as part of the Study of Post-Deployment Mental Health. Participants (N = 1,118) had served in the US military since September 11, 2001, had one or more overseas deployments, and were free from a past-month DSM-defined mental health disorder. Hierarchical linear regression was used to examine the association between poor sleep quality (Pittsburgh Sleep Quality Index total score) and psychological distress (Global Symptom Index; Symptom Checklist-90-R), controlling for demographic and health characteristics. Moderation analyses tested for a potential buffering effect of resilience (Connor-Davidson Resilience Scale). Poor sleeping Veterans had worse physical and psychological health, lower resilience, and endorsed more lifetime traumatic events. Poor sleep was associated with greater psychological distress controlling for health and demographic characteristics. Both resilience factors—adaptability and self-efficacy—had significant buffering effects on the relationship between poor sleep and psychological distress, suggesting that resilience may protect against negative outcomes in poor sleepers. Additional research is warranted to better understand the relationships between sleep, resilience, and psychological distress. Such research may inform pertinent prevention efforts, including interventions that improve sleep, enhance resilience, and protect against incident mental health diagnoses.     

An Examination of Alcohol Use Disorder Symptoms and Neighborhood Disorganization from Age 21 to 39

Living in disorganized neighborhoods characterized by high levels of poverty, crime, violence, and deteriorating buildings has been associated with increased alcohol consumption and mental health problems. Data drawn from the Seattle Social Development Project (N = 790), a theory‐driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of Alcohol Use Disorder (AUD) symptoms from age 21 to 39. Time‐varying measures of neighborhood disorganization, psychological distress, and sociodemographic factors were associated with deviations from average AUD symptoms at each wave. Results indicated that, on average, AUD symptoms decreased as individuals got older. Living in more disorganized neighborhoods and experiencing psychological distress was associated with increased AUD symptoms after accounting for average reductions from AUD symptoms over time and time‐varying measures of relevant sociodemographic factors. Results of mediation analysis suggested that psychological distress is a mechanism by which disorganized neighborhoods increased risk of AUD from age 21 to 39.     

Comparing educational interventions: Correcting misperceived norms improves college students' mental health attitudes

This research targeted potential psychological contributors to college students' low levels of help‐seeking for mental distress using a field experiment. Researchers randomly assigned 520 undergraduates to 15‐min interventions: a novel, theory‐driven social norms intervention correcting misperceived distress, stigma, and help‐seeking norms; a general education intervention increasing mental health awareness; and a stress management active control condition. The norms intervention instilled more accurate perceptions of mental health norms and temporarily reduced perceived public stigma compared to other conditions. The norms and general education interventions improved attitudes toward seeking help for mental distress for at least 2 months, relative to the control. Effects on help‐seeking behavior were not observed in this timeframe. This research elucidates the robustness of brief social psychological mental health interventions on college campuses.     

Comment on “The Self‐Care of Psychologists and Mental Health Professionals” (Dattilio, 2015)—Working With the Mentally Ill Is a Mental Health Hazard: What Can We Do About It?

It has been known for many decades that the risk of burnout, psychological distress, mental illness, or suicidal ideation is higher in mental health professionals (MHP) compared with many other professions and the general population; however, MHPs often disregard their own mental health for the sake of helping others, sometimes with fatal consequences. Paradoxically MHP tends to avoid seeking professional help for their own mental health issues. Apart from the serious risk to one's health that this poses, MHPs are now mandated to report any impairment that affects their ability to practice. The aim of this commentary is to emphasise the heightened risk of mental illness among MHP, and includes some risk factors associated with burnout, psychological distress, or mental illness in MHP. It explores some of the barriers to help seeking, including stigma, and highlights mindfulness as a self‐care strategy to prevent psychological distress and burnout. The commentary makes recommendations for inclusions into current psychology postgraduate as well as undergraduate curriculum. It concludes with recommendation for suitable support from professional bodies to help maintain good mental health and to help prevent mental illness among MHPs.     

Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders

Acceptance and commitment therapy (ACT) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants. The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders, and examining whether results differ for psychologically inflexible versus flexible individuals. A sample of college students (N =95) was randomly assigned to a 2(1)2h ACT or educational workshop. Measures were taken before and after the workshop and at a 1-month follow-up. ACT reduced mental health stigma significantly regardless of participants' pre-treatment levels of psychological flexibility, but education reduced stigma only among participants who were relatively flexible and non-avoidant to begin with. Acceptance could be an important avenue of exploration for stigma researchers.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

Symptoms of Psychological Distress Among Mothers and their Adult Offspring: A Longitudinal Examination

We examined the association between maternal psychological distress during offspring’s early development and offspring’s later distress in adulthood, as well as the influence of maternal characteristics at offspring’s birth and offspring’s characteristics in adulthood on distress. Data were obtained from the British Cohort Study, a longitudinal study of children born in a one-week period in 1970. Children were followed up multiple times from birth through to age 30. Results indicate that greater symptoms of maternal psychological distress during offspring’s early childhood are associated with greater symptoms of distress in adult offspring. A large component of this association is indirect, occurring through mother’s distress in later childhood and offspring’s problem behavior during adolescence. Findings that the association between maternal and offspring’s distress is more indirect than direct support arguments that early maternal distress has long-term consequences for offspring.     

A geography of contaminated sites,mental health and wellbeing: The body,home, environment and state at Australian PFAS sites

Health geographers have long been interested in the connection between place and mental health, proposing that settings influence mental health and vice versa. Research on environmental contamination has tended to focus on the former part of this relationship, examining how the mental health and wellbeing of residents living nearby are affected by the contamination. There has been little investigation of the latter component: how mental health and wellbeing may shape place. This article seeks to explore how the mental health and wellbeing of residents living on or near environmental contamination may be both affected by and reproduced in place. It considers this in a case study of per- and poly-fluoroalkyl substances (PFAS) contamination in New South Wales, Australia, by drawing on interviews with residents. Focus is placed on examining how residents report psychological distress associated with the contamination and how this distress may permeate beyond the contaminated site to become enmeshed in other places at different scales, such as the body, home, local environment, and state. Ultimately, it is proposed that these places reproduce distress on their own and require just as much attention in addressing adverse psychological effects as the physical contamination itself.     

Preliminary Evidence of Differences Between Stigma Source Versus Type With Individual Functioning Variables in National Guard/Reserve Troops

Extant military studies show that stigma has a variable association with seeking mental health treatment and mental health distress. Previous studies used a general measure of stigma that does not differentiate between stigma source or type. Stigma source can be either self-perceived or perceived from others, and stigma type can include stigma for disorder or stigma for help-seeking. Civilian literature demonstrates that self-stigma is more detrimental to individual functioning than stigma perceived from others, and prior studies in National Guard service members (NGSMs) show that self-stigma and stigma perceived from unit leaders were associated with lower help-seeking intentions relative to stigma perceived from unit members or family members. No military study has simultaneously explored the associations of demographic and distress variables with various stigma types and sources. To determine if prior mixed findings were due to the use of a general measure of stigma, NGSMs (n = 163) completed demographic and distress measures, as well as stigma source (e.g., self, leader) and type (i.e., general, disorder, help-seeking) assessments. General stigma was positively associated with all stigma types and sources as well as a college education. Disorder stigma was positively associated with stigma from nonmilitary sources, and self-stigma for help-seeking was negatively associated with help-seeking intentions. Likelihood of deploying again was positively associated with disorder and help-seeking stigma when perceived from someone in authority. Given the unique associations observed, future studies should utilize specific measures of stigma when examining factors related to postdeployment functioning.     

Psychological Distress and Help Seeking in Rural America

The implications of exposure to acute and chronic stressors, and seeking mental health care, for increased psychological distress are examined. Research on economic stress, psychological distress, and rural agrarian values each point to increasing variability within rural areas. Using data from a panel study of 1,487 adults, a model predicting changes in depressive symptoms was specified and tested. Results show effects by size of place for men but not for women. Men living in rural villages of under 2,500 or in small towns of 2,500 to 9,999 people had significantly greater increases in depressive symptoms than men living in the country or in larger towns or cities. Size of place was also related to level of stigma toward mental health care. Persons living in the most rural environments were more likely to hold stigmatized attitudes toward mental health care and these views were strongly predictive of willingness to seek care. The combination of increased risk and less willingness to seek assistance places men living in small towns and villages in particular jeopardy for continuing problems involving depressed mood.     

Religious Orientation, Mature Faith, and Psychological Distress: Elements of Positive and Negative Associations

There are substantial data exploring the link between religiousness and health, yet there is little consensus regarding the nature of the relationship between religiousness domains and mental health. The purpose of this study was to identify the types of mental health outcomes associated with religiousness domains. Participants included 251 ( M = 19.02; range = 17–25) young adults who completed self-report measures of religiousness (Intrinsic, Extrinsic, and Quest Orientations, Faith Maturity Scale), and psychological distress subscales (SCL-90-R). We identified significant relationships between each of the religiousness measures and the SCL-90-R subscales and analyzed the relative contributions of each of the religiousness measures in predicting psychological distress with hierarchical multiple regression. The Faith Maturity Scale was a particularly robust predictor of positive and negative psychological adjustment. The specific pathways by which religiousness influences mental health outcomes remain to be elaborated in future research.     

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.     

Development of the Coping Flexibility Scale: evidence for the coping flexibility hypothesis

Coping flexibility was defined as the ability to discontinue an ineffective coping strategy (i.e., evaluation coping) and produce and implement an alternative coping strategy (i.e., adaptive coping). The Coping Flexibility Scale (CFS) was developed on the basis of this definition. Five studies involving approximately 4,400 Japanese college students and employees were conducted to test the hypothesis that flexible coping produces more adaptive outcomes. Studies 1, 2, and 3 provided evidence of the reliability of the CFS scores as well as of its convergent and discriminant validity for Japanese samples. Study 4 further demonstrated that flexible coping was positively associated with improved psychological health, including reduced depression, anxiety, and distress. In Study 5, coping flexibility as measured by the CFS was associated with reduced future depression, even after controlling for the effects of other coping flexibility measures and popular coping strategies. Overall, these results suggest that a valid approach for assessing coping flexibility has been developed and that flexible coping can contribute to psychological health. The implications of these findings for clinical practice are discussed.     

Attitudes toward seeking professional psychological help among Chinese students at a UK university

Aim: In this study we aimed to investigate whether Chinese international and British home students at a university in the United Kingdom differed in their attitudes towards seeking psychological help. Method: The total sample comprised 323 participants. Participants completed measures to assess their attitudes toward seeking professional psychological help (recognition of need for psychological help, stigma tolerance, interpersonal openness, confidence in mental health practitioners). Results: Chinese students reported significantly less interpersonal openness than that reported by British students. Contrary to prediction, however, no significant group differences were found on any of the other mental health attitudes (i.e. recognition of need for psychological help, confidence in mental health practitioners or stigma tolerance). Within‐group contrasts also showed that Chinese students reported lower scores on interpersonal openness than on stigma tolerance and confidence in mental health practitioners. In contrast, British participants reported less confidence in mental health practitioners and recognition of the need for psychological help than reported for stigma tolerance and interpersonal openness. Conclusion: The findings highlight the need for a greater understanding of students' cultural inclinations toward mental health issues and cultural attitudes that may hinder and/or facilitate students' access and engagement with psychological services in higher education institutions.     

Prevalence and correlates of psychological distress of middle-aged and older women living with HIV

The aims of this study were to examine the prevalence and correlates of psychological distress among older women living with HIV in comparison to their male counterparts and younger women and to identify the sociodemographic and disease-related factors associated with psychological distress. The sample consisted of 508 HIV-infected patients (65 older women, 323 women aged below 50 years, and 120 older men) recruited from 10 Portuguese hospitals. Data regarding psychological distress were collected using the Brief Symptom Inventory (BSI). Seven older women (10.8%), eight older men (6.7%), and 61 younger women (18.9%) reported a T-score ≥ 63 for global severity index (GSI), indicative of a need for further psychological evaluation. Overall, younger women reported significantly higher psychological distress than older men. The odds of having clinically significant psychological distress score were significantly lower for older women reporting sexual transmission, while for younger women, having other co-infections was a significant correlate of higher psychological distress. Younger women were 2.67 (95% CI: 1.22–5.84) times more likely to report psychological distress than were older men. The odds were not significantly different from older women. This study shows that older women do not differ substantially from younger women and older men in terms of psychological distress. The results reinforce, however, that mental health interventions should be tailored to reflect individuals’ circumstances as well as developmental contexts. Moreover, they draw attention to the importance of examining resilience characteristics in older adults to understand the mechanisms behind ‘successful ageing’ while living with HIV.     

The Effect of Stigma on Criminal Offenders’ Functioning: A Longitudinal Mediational Model

Research has rarely considered criminal offenders’ psychological responses to stigma, but these responses may significantly influence behavior after release from jail/prison. Jail inmates’ perceived and anticipated stigma was assessed prior to release from jail/prison (N = 163), and outcomes were assessed one year post-release (N = 371). We hypothesized that perceived stigma would predict poor adjustment in several domains (i.e., recidivism, substance dependence, mental health symptoms, community adjustment) through anticipated stigma. Results showed that perceived stigma predicted worse community adjustment through anticipated stigma, and this varied by race. Results are explored from an interdisciplinary perspective.