Sex, race/ethnicity, and romantic attractions: multiple minority status adolescents and mental health

This study examined the association between multiple minority statuses and reports of suicidal thoughts, depression, and self-esteem among adolescents. Data from the National Longitudinal Study of Adolescent Health were used to examine mental health outcomes across racial/ethnic groups for same-sex-attracted youths and female youths. Hispanic/Latino, African American, and White female adolescents reported more suicidal thoughts, higher depression, and lower self-esteem compared with male adolescents in their racial/ethnic group. Same-sex-attracted youths did not consistently demonstrate compromised mental health across racial/ethnic groups. Follow-up analyses show that White same-sex-attracted female adolescents reported the most compromised mental health compared with other White adolescents. However, similar trends were not found for racial/ethnic minority female youths with same-sex attractions.     

Conceptualizing Culturally Infused Engagement and Its Measurement for Ethnic Minority and Immigrant Children and Families

Despite the central role culture plays in racial and ethnic disparities in mental health among ethnic minority and immigrant children and families, existing measures of engagement in mental health services have failed to integrate culturally specific factors that shape these families’ engagement with mental health services. To illustrate this gap, the authors systematically review 119 existing instruments that measure the multi-dimensional and developmental process of engagement for ethnic minority and immigrant children and families. The review is anchored in a new integrated conceptualization of engagement, the culturally infused engagement model. The review assesses culturally relevant cognitive, attitudinal, and behavioral mechanisms of engagement from the stages of problem recognition and help seeking to treatment participation that can help illuminate the gaps. Existing measures examined four central domains pertinent to the process of engagement for ethnic minority and immigrant children and families: (a) expressions of mental distress and illness, (b) causal explanations of mental distress and illness, (c) beliefs about mental distress and illness, and (d) beliefs and experiences of seeking help. The findings highlight the variety of tools that are used to measure behavioral and attitudinal dimensions of engagement, showing the limitations of their application for ethnic minority and immigrant children and families. The review proposes directions for promising research methodologies to help intervention scientists and clinicians improve engagement and service delivery and reduce disparities among ethnic minority and immigrant children and families at large, and recommends practical applications for training, program planning, and policymaking.     

Ethnic minority adolescents and the use of community mental health care services

Examined the utilization rates, treatment dropout rates, and length of treatment for minority adolescents in the mental health care system. Data from the Los Angeles County Department of Mental Health from 1983 to 1988 were used. Ss were 853 African Americans, 704 Asian Americans, 964 Hispanics, and 670 whites. Analyses showed that Asian Americans and Hispanics are underrepresented in existing public mental health facilities while African Americans are overrepresented. For dropout rates, no ethnic differences are found between minority groups and whites; but, for length of treatment, Asian Americans tend to stay longer in treatment while African Americans tend to stay in treatment for a shorter period of time than whites. African Americans also have more outpatient episodes than whites. Implications of the results are discussed, and recommendations for future research are suggested.     

Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth

Misdiagnoses of racial/ethnic minority youth’s mental health problems can potentially contribute to inappropriate mental health care. Therefore, we conducted a systematic review that focuses on current theory and empirical research in an attempt to answer the following two questions: (1) What evidence exists that supports or contradicts the idea that racial/ethnic minority youth’s mental health problems are misdiagnosed? (2) What are the sources of misdiagnoses? Articles were reviewed from 1967 to 2014 using PsychINFO, PubMed, and GoogleScholar. Search terms included “race”, “ethnicity”, “minority”, “culture”, “children”, “youth”, “adolescents”, “mental health”, “psychopathology”, “diagnosis”, “misdiagnosis”, “miscategorization”, “underdiagnosis”, and “overdiagnosis”. Seventy-two articles and book chapters met criteria and were included in this review. Overall, evidence was found that supports the possibility of misdiagnosis of ethnic minority youth’s emotional and behavioral problems. However, the evidence is limited such that it cannot be determined whether racial/ethnic differences are due to differences in psychopathology, mental health biases, and/or inaccurate diagnoses. Cultural and contextual factors that may influence misdiagnosis as well as recommendations for research and practice are discussed.     

Psychosocial treatment research with ethnic minority populations: ethical considerations in conducting clinical trials

Because of historical mistreatment of ethnic minorities by research and medical institutions, it is particularly important for researchers to be mindful of ethical issues that arise when conducting research with ethnic minority populations. In this article, we focus on the ethical issues related to the inclusion of ethnic minorities in clinical trials of psychosocial treatments. We highlight 2 factors, skepticism and mistrust by ethnic minorities about research and current inequities in the mental health care system, that researchers should consider when developing psychosocial interventions studies that include ethnic minorities.     

An examination of the cross-ethnic equivalence of measures of negative life events and mental health among Hispanic and Anglo-American children

Recently there has been concern over the need for mental health research within ethnic minority populations, particularly Hispanic populations. Although there has been research focusing upon the similarity of mental health problems among Hispanic and Anglo-American samples, the absence of information regarding the cross-ethnic measurement equivalence of the assessment tools used in these comparisons seriously limits the interpretability of these findings. The two reported studies were designed to (a) examine the cross-ethnic functional and scalar equivalence of several mental health measures by examining the interrelations of these mental health indicators and examining the regression equations using negative life events to predict mental health outcomes; and (b) compare several mental health indicators among Hispanic and Anglo-American 8- to 14-year-old children. Findings suggest considerable cross-ethnic functional and scalar equivalence for the measure of depression, conduct disorders, and negative life events. In addition, findings indicate that the Hispanic children scored higher in depression than did the Anglo-American children, but this difference could be a function of differences in SES. The reader is cautioned that the present samples included only English-speaking and primarily Mexican American children. This study was funded by the National Institute for Mental Health Grant 2-P50-MH39246-06 to support the Preventive Intervention Research Center at Arizona State University. The authors gratefully acknowledge the contributions made by Tim Ayers, Carolyn Berg, Leah Gensheimer, Joanne Gersten, Nancy Groppenbacher, Lisa Jack, Lillian Lengua, Marcia Michaels, Irwin Sandler, and Jerome Short.     

Cultural competence and evidence-based practice in mental health services: a complementary perspective

The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed.     

At the crossroads: managed mental health care,the ethics code,and ethnic minorities

Mental health clinicians are facing an increasing number of ethical problems related to the delivery of managed mental health care services to ethnic minorities. The authors argue that (a) economic pressures have led to the development of the managed health care movement; (b) the combination of such economic pressures and the development of that managed care movement have influenced the promulgated ethical standards of the American Psychological Association; and (c) those influences may have a negative impact on the mental health services available to ethnic minority individuals and communities. The authors review some of the specific potential threats to mental health services for minorities in the face of such health management policy and psychologists' professional standards.     

An Examination of the Impact of Minority Status Stress and Impostor Feelings on the Mental Health of Diverse Ethnic Minority College Students

This study examined differences in minority status stress, impostor feelings, and mental health in a sample of 240 ethnic minority college students. African Americans reported higher minority status stress than Asian Americans and Latino/a Americans, whereas Asian Americans reported higher impostor feelings. Minority status stress and impostor feelings were examined as predictors of mental health. Impostor feelings were stronger predictors of mental health than minority status stress. Counseling implications for ethnic minority students are discussed. Este estudio examinó las diferencias en estrés por estatus de minoría, sentimientos de impostor, y salud mental en una muestra de 240 estudiantes universitarios pertenecientes a minorías étnicas. Los afroamericanos comunicaroun un estrés por estatus de minoría más alto que los asiático‐americanos y los latinoamericanos, mientras que los asiático‐americanos comunicaron sentimientos de impostor más elevados. Se examinaron el estrés por estatus de minoría y los sentimientos de impostor como predictores de salud mental. Los sentimientos de impostor fueron predictores más fuertes de salud mental que el estrés por estatus de minoría. Se discuten las implicaciones en consejería para estudiantes de minorías étnicas.     

Family Contexts: Parental Experiences of Discrimination and Child Mental Health

Research on the mental health correlates of discrimination traditionally has been intra-individual, focusing exclusively on the individual directly experiencing discrimination. A small number of studies have begun to consider the links between parental experiences of discrimination and child mental health, but little is known about potential underlying mechanisms. The present study tested the independent mediating effects of parent mental health and household socioeconomic status on the associations between parental experiences of discrimination (past-year perceived discrimination and perceptions of being unaccepted culturally) and child mental health (internalizing and externalizing symptoms) using a bootstrapping analytic approach. Data were drawn from racial/ethnic minority (n = 383) and White (n = 574) samples surveyed in an urban Midwestern county. For all measures of discrimination and child mental health, findings supported an association between parental experiences of discrimination and child mental health. Whereas parent mental health served as a significant mediator in all analyses, socioeconomic status did not. Mediation findings held for both the White and racial/ethnic minority samples. Results suggest that parental experiences of discrimination and mental health may contribute to child mental health concerns, thus highlighting the role of family contexts in shaping child development.     

Psychological testing for Hispanic Americans

The need for culturally responsive mental health services for Hispanic Americans has never been greater. This population will soon become the largest of all U.S. ethnic minority groups, and recent epidemiologic studies suggest that Hispanics have rates of mental health need that are similar to those found in the general population. Developing culturally relevant mental health services, including diagnostic and assessment procedures, for this population is essential. A synthesis of extant literature pertaining to psychological testing for Hispanics is presented. It is limited to the adult literature and discusses issues related to personality, neuropsychological, and intellectual assessment. The importance of language as it influences the assessment process has also been discussed. Based on clinical and research experiences and the results of the literature review, a set of general guidelines is proposed for those working with this population.     

Racial/Ethnic Identity and Subjective Physical and Mental Health of Latino Americans: An Asset Within?

Social Identity Theory indicates that ethnic identity could benefit minority members in a society because of its promotion of a sense of belonging, or of its buffering of the damage of discrimination. Despite growing investigation about Latinos’ overall health, few studies have simultaneously examined the influence of multiple cultural strength factors, especially racial/ethnic identity, social support, and religious attendance, on these outcomes. Using the National Latino and Asian American Study, we examine the potential predictive value of these cultural strength factors on Latinos’ Self-Rated Mental and Physical Health (SRMH and SRPH). Two separate two-step regression models revealed significant positive effects of racial/ethnic identity on both mental and physical health of Latinos, above and beyond the effect of known demographic and acculturation factors, such as discrimination. Religious attendance had a positive effect on SRMH but not on SRPH. The deteriorating roles of discrimination, in mental health only, and that of Length in the US in both outcomes, however, was primarily not altered by entry of these cultural strength factors. The independent direct effect of racial/ethnic identity among Latinos nationwide may suggest that this cultural strength is an internalized protective asset. Longitudinal data is needed to explore its underlying mechanism and long-term impact.     

An Examination of the Impact of Racial and Ethnic Identity,Impostor Feelings,and Minority Status Stress on the Mental Health of Black College Students

This study examined ethnic identity, racial centrality, minority status stress, and impostor feelings as predictors of mental health in a sample of 218 Black college students. Ethnic identity was found to be a significant positive predictor of mental health, whereas minority status stress and impostor feelings were significant negative predictors. Although ethnic identity was the strongest predictor of mental health, racial centrality represented a nonsignificant, negative predictor. Counseling implications for Black college students are discussed. Este estudio examinó la identidad étnica, la centralidad racial, el estrés por estatus de minoría y los sentimientos de impostor como indicadores de salud mental en una muestra de 218 estudiantes universitarios negros. Se halló que la identidad étnica es un indicador positivo significativo de salud mental, mientras que el estrés por estatus de minoría y los sentimientos de impostor fueron indicadores negativos significativos. Aunque la identidad étnica fue el indicador más fuerte de salud mental, la centralidad racial representó un indicador negativo no significativo. Se discuten las implicaciones para la consejería de estudiantes universitarios negros.     

Asians as the model minority: Implications for US Government's policies

Asian Americans are often perceived as a 'model minority'– an ethnic minority that are high achieving, hardworking, self-reliant, law-abiding, as well as having few social and mental health problems. Although the impact of the model minority image on the US government's redistributive policies is a widely contested topic in public discourses, there has been little research on the association between the model minority image, people's worldviews, and attitudes towards the US government's redistributive policies. In an experiment that measured American participants' worldviews and manipulated the salience of the model minority image, we have demonstrated that those who believed in a malleable social reality were relatively unsupportive of government policies that help the Asian American ( vs African American) communities. Theoretical and practical implications of this finding are discussed.     

Structure and function of the perceived acculturation context of young Moroccans in the Netherlands

T he goals of this research were twofold: (1) to explore the structure of the perceived acculturation context in a group of 155 Moroccan adolescents and young adults living in the Netherlands, and (2) to examine to what extent this structure can predict quality of relationships, success, and mental health. The perceived acculturation context turned out to be multidimensional and its dimensions independent. The perceived mainstream context consisted of a tolerance factor and an integration factor while the perceived minority context consisted of a permissiveness to adjust factor and an ethnic vitality factor. A path model in which both the perceived mainstream and minority contexts predicted acculturation outcomes showed a good fit. The effects flowed from context to relationships to success to acculturative stress, were both direct and indirect, and showed the expected signs. Both perceived mainstream context and perceived minority context were more or less equally, though distinctly, important. While the mainstream context was crucial for work success, the minority context remained especially important in leading to school success and good mental health. A good fit was found for a model in which sociocultural adaptation preceded psychological adaptation and within the sociocultural component of adaptation, quality of relationships preceded school success, which, in turn, preceded work success.     

How changes in population demographics will impact health psychology: incorporating a broader notion of cultural competence into the field.

U.S. population demographics are undergoing striking changes that will impact health care and the research and practice of health psychology. An increase in the number of people who are older; belong to an ethnic minority group; have disabilities; identify as lesbian, gay, bisexual, or transgendered; or live in poverty will influence definitions of aging, health, and illness, and will challenge current psychological and medical treatment models. The authors argue that health psychologists need to become context competent for the field to be relevant and viable over the course of this new century. Health psychologists need to become aware of the multiple, overlapping contexts in which people live and apply this knowledge on a regular basis to research, practice, education and training, and policy in health psychology.     

Intake Concerns of Racial and Ethnic Minority Students at a University Counseling Center: Implications for Developmental Programming and Outreach

The presenting concerns of racial and ethnic minority students at a university counseling center were examined. Results revealed that family and romantic relationship issues, academic concerns, and depression were among their primary concerns. Implications for developing outreach programs to address the mental health needs of similar college students are discussed.     

The Conceptualization of Anxiety: An Exploratory Study of Japanese American Older Adults

Few empirical studies exist on the mental health of Japanese American older adults. This study focused on how Japanese American older adults conceptualize anxiety. Participants were presented with a checklist, which included anxiety and depression symptoms identified in a previous qualitative study conducted by the authors, as well as symptoms from Generalized Anxiety Disorder in the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IVrpar;. They were asked to imagine a Japanese American older adult who was experiencing anxiety and check off the symptoms he/she would be experiencing. Results indicated that these Japanese American participants conceptualized anxiety by using more depressive symptoms than anxiety symptoms. In addition, contrary to previous research and speculation about how Asian Americans experience psychological distress, participants also checked a larger number of cognitive symptoms as opposed to somatic symptoms. The present data suggest that Japanese American older adults conceptualize anxiety differently from the traditional psychiatric conceptualization of anxiety. Thus, clinicians and researchers should not generalize symptoms of psychological distress developed and researched on nonminority older adults to ethnic minority adults, and should consider such ethnic group differences in their assessment and treatment methods for ethnic minority adults.     

Provider Perspectives about Latino Patients: Determinants of Care and Implications for Treatment

Primary care settings are the gateway through which the majority of Latinos access care for their physical and mental health concerns. This study explored the perspectives of primary care providers regarding their Latino patients, particularly, issues impacting their patients' access to and utilization of services. Interviews were conducted with eight primary care providers-and analyzed using consensual qualitative research methods. In addition, observations were conducted of the primary care setting to contextualize providers' perspectives. Providers indicated that care for Latinos was impacted by several domains: (a) practical/instrumental factors that influence access to care; (b) cultural and personal factors that shape patients' presentations and views about physical and mental health and treatment practices; (c) provider cultural competence; and (d) institutional factors which highlight the context of care. In addition to recommendations for research and practice, the need for interdisciplinary collaboration between psychology and medicine in reducing ethnic minority disparities was proposed.