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- Creators: Arizona State University
- Creators: Kurpius, Sharon
Description
Every year an alarming number of deaths for the Black community are a result of disparities and inequalities in health outcomes. While literature has largely focused on social determinants of heath (e.g., economic, environmental, biological, and behavioral structures) as contributing factors to disparate health outcomes for Black people, literature on medical mistrust has been on the rise. Medical mistrust is defined as the belief that health care entities and providers act against a patient's best interest and well-being, and is associated with lower rates of service utilization, inadequate management of health conditions, lower levels of involvement in research, and treatment nonadherence. Only recently has patient-centered care been examined as a construct that may reduce the negative effects of medical mistrust. This study examined Black identifying patients (N = 174) across gender and their reported levels of medical mistrust, and if the perception of a patient-centered health care environment would moderate the association. The findings indicated that Black females, compared to Black males, endorsed higher levels of medical mistrust that may be indicative of intersectional influences. While there were significant effects of gender and perceived patient-centered care on medical mistrust, perceived patient-centered care was not found to significantly moderate the relationship between gender identity and medical mistrust. This may be indicative of the varying degrees of medical maladies that may be stronger determinants of perceived patient-centered care, despite gender or other demographic characteristics. Implications for practice and future research on the intersectional influences on medical mistrust and perceived patient-centered care in the Black communities are discussed.
ContributorsMatthews, Tianna (Author) / Warner, Cheryl (Thesis advisor) / Randall, Ashley K (Committee member) / Dillon, Frank (Committee member) / Arizona State University (Publisher)
Created2021
Description
The Latinx population in the United States is projected to increase exponentially in upcoming years. Latina women in particular are put at disproportionate risk of experiencing psychological distress after immigrating to the US. Separation from family upon immigration introduces more difficulty to the immigration experience. Yet protective factors such as family cohesion may buffer potential psychological distress. The present study will examine the two following research questions. First, is there a difference in psychological distress experienced by Latina young women who report separating from their family in comparison to those who did not experience familial separation at immigration. Second, does a potentially deleterious effect of immigration on familial attachment underlie or mediate the hypothesized positive association between separation at immigration and psychological distress. Participants were Latina young women who ranged from 18-23 years-old, were unmarried, and had to have resided in the US for 36 months or less. I used structural path analysis to examine hypothesized associations among separation status, attachment to family, and psychological distress. Findings aim to inform mental health interventions for Latina young adults who immigrate to the US without family.
ContributorsRomero, Abigail (Author) / Dillon, Frank (Thesis advisor) / Pereira, Jennifer (Committee member) / Buckman, Lindsey (Committee member) / Arizona State University (Publisher)
Created2021
Description
The onset of the COVID-19 pandemic during the spring of 2020 necessitated a sudden and national transition from in-person to telehealth mental health services. Burgeoning literature has supported the use of telehealth services generally, though there is little research related to its use among graduate-level trainees. The present study utilized data collected from a university counseling training center to compare client outcomes, namely ratings of depression and anxiety, between in-person (pre-pandemic; n = 86) and telehealth (intra-pandemic; n = 102) groups. Additionally, I examined treatment format (in-person vs. telehealth) as moderator of the association between client-reported working alliance and client-reported outcomes. Results showed a significant and negative effect of the working alliance on symptoms of depression and anxiety regardless treatment format. Implications for research and practice are discussed.
ContributorsGerton, Jessica M (Author) / Spanierman, Lisa (Thesis advisor) / Bludworth, James (Thesis advisor) / Dillon, Frank (Committee member) / Arizona State University (Publisher)
Created2022
Description
Emerging adulthood (18 – 28 years) is a distinctive period in the life course whereyoung people are involved in the process of transitioning to adult roles in their careers
and social relationships. Due to the ongoing COVID- 19 pandemic, economic instability,
and other social factors, emerging adults in the United States are experiencing greater
stress and challenges than ever before. In this climate of high stress, personal
characteristics such as an individual’s propensity to endorse sociotropy (the tendency to
focus primarily on relationships) or autonomy (the tendency to focus primarily on the
self) may be associated with experiences of stress and resulting depressive feelings based
on the diathesis-stress model of depression proposed by Beck in 1967. However,
perceived partner’s dyadic coping may buffer against the positive association between
stress and depression. Despite this plausible link, not much is known about how personal
characteristics (here sociotropy and autonomy) of emerging adults may influence their
perceptions of their own as well as partner’s dyadic coping. To address this gap, the
present study used survey data from 269 emerging adults to examine whether personal
characteristics such as sociotropy and autonomy are associated with their perceptions of
dyadic coping and to examine if these associations are moderated by perceived
relationship commitment, given commitment has been found to increase relationship
maintenance behaviors. Results found that both sociotropy and autonomy were associated
positively with positive dyadic coping by self and negatively with negative dyadic coping
by partner. Relationship commitment partially moderated these associations. Results of
this study have the ability to inform therapy for emerging adults in romantic relationships
who may be experiencing higher stress, symptoms of depression, and those who may be
experiencing difficulties in their relationships. Limitations and future directions for
research are discussed
ContributorsGandhi, Yuvamathi (Author) / Randall, Ashley K (Thesis advisor) / Bludworth, Jamie (Committee member) / Warner, Cheryl (Committee member) / Iida, Masumi (Committee member) / Arizona State University (Publisher)
Created2023
Description
Research examining the psychosocial correlates of mental and behavioral health among Latinx populations during the COVID-19 pandemic is limited. This is problematic given that Latinx communities in the U.S. find themselves at the intersection of worse COVID-19-related mortality, mental health distress, and health outcomes. These COVID-19 related disparities came at a time when U.S. Latinxs were already experiencing a disproportionate burden of mental health and substance use disease. Health disparities research has largely focused on Latinxs as a monolithic group, yet in doing so, the intersectionality of race, ethnicity, and socioeconomic status on health are overlooked. It is critical to understand the mental health needs of Latinxs in light of the current COVID-19 pandemic as well as the challenges and potential barriers to services experienced by these communities to better meet their unique needs. Therefore, Study 1 aimed to investigate differences on pandemic-related stressors along economic, emotional, and physical domains, psychological distress, and substance use, based on Latinx ethnicity. The second aim of Study 1 was to identify the most significant pandemic-related stressors and challenges faced by specific Latinx subgroups. Study 2 built off of the results from Study 1. Specifically, Study 2 investigated the association between pandemic-related economic, emotional, and physical stressors examined in Study 1 to various health and mental health outcomes including, psychological distress, alcohol use, and drug use, reported during the pandemic by different Latinx ethnic groups.
ContributorsFlorez, Jennifer Elizabeth (Author) / Capielo-Rosario, Cristalís (Thesis advisor) / Dillon, Frank (Committee member) / Truong, Nancy (Committee member) / Arizona State University (Publisher)
Created2024
Description
A high percentage of Native Hawaiian and other Pacific Islander (NHPI) adults (37.4%) aged 18 and older did not see a doctor in the past year. This is the highest percentage among all racial groups. Furthermore, approximately one in eight NHPI adults (12%) are uninsured, a rate that is markedly higher than Whites. Federal reports historically struggle to capture data that could explain these phenomena. Hence, NHPI are insufficiently and incompletely represented in health statistics, access health services at lower rates, and are insured at lower rates than other racial and ethnic minority groups. This has implications for perpetuating adverse mental health conditions and mental health disparities that are prevalent in this community (e.g., depression, anxiety, alcohol use disorder, and tobacco use), particularly following the global COVID-19 pandemic. The overarching goal of this research is to improve and broaden understanding of novel multi-level health determinants causing low mental health care service utilization rates of NHPIs, a presently understudied health disparity for Native Hawaiians and other Pacific Islanders in the U.S. Design: A closed access, cross-sectional Internet survey was used to collect data. Participants were recruited with announcements distributed nationwide via email to NHPI organizations, associations, and networks across the United States and social media. The sample included 395 NHPI adults aged 18 and older. Analysis: Latent profile analysis (LPA) were conducted using Mplus 8 statistical software to examine whether different conceptually meaningful profiles of NHPI Islanders emerge based on hypothesized health determinants measuring Symptom Distress (Perceived Health Status, Depression/Anxiety, and Perceived Stress), Protective Factors (Pacific Cultural Efficacy, Religious Centrality and Embeddedness, Pacific Connectedness and Belonging, and Perceived Societal Wellbeing) and Health Attitudes (Medical Mistrust and Service Provider Preferences [i.e., Traditional/Native Healer vs Medical Doctor/Nurse]) while accounting for demographic covariates (e.g., education, income, and insurance status). Results supported a four-profile model solution, where four distinct groups (named “Very Low Symptomatic,” “Low Symptomatic,” “Moderate Symptomatic,” and “High Symptomatic”) of participants demonstrated varying levels of symptom distress, endorsement of protective factors, and health attitudes. Furthermore, planned mental health care utilization was analyzed as an outcome variable, demonstrating varying levels of planned mental health service utilization across the four profiles. Significance: Findings may inform public policy and healthcare professionals about how to meaningfully engage NHPI communities in culturally competent mental health care services.
ContributorsMarsiglia, Steven Sasa (Author) / Dillon, Frank R (Thesis advisor) / Yellow Horse, Aggie J (Committee member) / Truong, Nancy N (Committee member) / Arizona State University (Publisher)
Created2024
Description
Colonial mentality describes how oppressed groups internalize the colonial narratives that have dehumanized them and made them subject to extreme physical, economic, and psychological violence rooted in racism and White supremacy. Beyond lacerating individuals’ identities, colonial mentality could also function as a mechanism to create intragroup conflicts. This exploratory study investigated how colonial mentality manifests through fragmentation and horizontal oppression among 13 Puerto Rican adults living in the United States. To do this, I examined the differences between their perception of the self and their perceptions of other Puerto Ricans. A thematic analysis yielded three themes: (a) fragmentation, (b) horizontal oppression, and (c) cognitive dissonance. Each theme had several subthemes portraying participants’ perceived differences in what makes an exemplary Puerto Rican juxtaposed with undesirable portrayals of being Puerto Rican. Results also portrayed how colonial mentality’s insidiousness is associated with ruptures, antagonization, and reproduction of oppression at the intragroup level. Within the last theme, however, participants’ language and narratives conveyed resistance to colonial mentality and an oasis for hope when battling coloniality at the interpersonal and relational levels. Findings from this study help expand the understanding of how colonial trauma also has significant effects on Puerto Ricans’ intragroup dynamics.
ContributorsRamos Rosado, Génesis (Author) / Capielo Rosario, Cristalís (Thesis advisor) / Matsuno, Em (Committee member) / Truong, Nancy (Committee member) / Arizona State University (Publisher)
Created2024
Description
Mental health stigma is a significant obstacle for those with mental health issues in and from the Middle East, defined as the countries of southwest Asia and North Africa including Afghanistan, Bahrain, Cyprus, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates, and Yemen. Such stigma may be passed down generationally; primary caregivers born in the Middle East who immigrate to the United States may pass down their beliefs and opinions of mental health to their children born in the U.S. This study examined the association between perceived primary caregiver mental health stigma and Middle Eastern emerging adults’ intention to seek mental help, while also examining the possible moderating effect of peer social support on this association. It was hypothesized that social support would mitigate the proposed negative association between a primary caregiver’s mental health self-stigma and their emerging adult child’s intention to seek mental health services. Results showed no significant association between perceived primary caregiver mental health stigma and an emerging adult’s intention to seek help, and no significant moderating effect of social support. However, findings showed a negative association between emerging adults’ mental health self-stigma and their help-seeking intention, as well as a positive association between prior counseling and help-seeking intention. Future implications of this research include bringing awareness to and addressing self-stigma in the Middle Eastern community, as well as providing education and training to those in the mental health field who may work with this population.
ContributorsSaka, Selin (Author) / Ahn, Lydia (Thesis advisor) / Randall, Ashley K (Thesis advisor) / Updegraff, Kimberly (Committee member) / Arizona State University (Publisher)
Created2024
Description
Despite the growing nonbinary population and their unique experiences, nonbinary people of color specific research remains scarce as most studies were done with predominantly white samples and failed to disaggregate transgender men and transgender women from nonbinary people. While parental acceptance and support (PAS) serve as protective factors for distal and proximal stressors-induced negative mental health outcomes among TNB youth, more research is needed to examine whether PAS play a role in nonbinary young adults of color’s mental health. Additionally, PAS may lead nonbinary young adults to internalize negative messages toward their gender identity, impacting mental health. This study aimed to examine whether PAS received by nonbinary young adults of color vary by race, whether PAS are associated with depression and suicidality, and whether these associations are mediated by internalized nonbinary negativity (INN) among nonbinary adults of color. Cross-sectional data from 174 nonbinary young adults of color were analyzed. Only parental support (PS) but not parental acceptance (PA) differed across racial groups. PAS were found to be negatively associated with depression and suicidality, but INN did not mediate the association between PS and negative mental health outcomes. Findings of this study reiterate the mental health disparities seen within the nonbinary community and serve as a call for attention to the effects of PAS in the lives of nonbinary young adults of color. Future research should inquire about the cultural values that influence PAS, ways to cultivate PAS among parents using existing cultural strengths, and the benefits of helping nonbinary young adults of color to maintain integral social support from parents.
ContributorsWong, Finneas (Author) / Matsuno, Em (Thesis advisor) / Ahn, Lydia (Committee member) / Randall, Ashley (Committee member) / Arizona State University (Publisher)
Created2024
Description
A growing body of research indicates that people of multiple racial lineages in the US encounter challenges to positive psychological adjustment because of their racial status. In response, they also exhibit unique resilience strategies to combat these challenges. In this study, the moderating roles of previously identified multiracial resilient factors (i.e., shifting expressions, creating third space, and multiracial pride) were examined in the associations between unique multiracial risk factors (i.e., multiracial discrimination, perceived racial ambiguity, and lack of family acceptance) and psychological adjustment (i.e., satisfaction with life, social connectedness, and distress symptoms) of multiracial adults. Drawing on risk and resilience theory, results first indicated that the multiracial risk factors (i.e., multiracial discrimination, perceived racial ambiguity, and lack of family acceptance) relate negatively with social connectedness and distress symptoms, but did not significantly relate with satisfaction with life. Additionally, a differential moderating effect for one multiracial resilient factor was found, such that the protective or exacerbative role of creating third space depends on the psychological outcome. Specifically, results suggest creating third space buffers (e.g., weakens) the association between multiracial discrimination and satisfaction with life as well as lack of family acceptance and satisfaction with life among multiracial adults. Results further suggest creating third space exacerbates (e.g., strengthens) the negative association between perceived racial ambiguity on social connectedness and distress symptoms as well as lack of family acceptance on social connectedness and distress symptoms. Moreover, no two-way interaction effects were found for either of the other multiracial resilient factors (i.e., shifting expressions and multiracial pride). This study highlights the complex nature of racial identity for multiracial people, and the nuanced risk and resilience landscape encountered in the US.
ContributorsJohnson, Preston (Author) / Yoo, Brandon (Thesis advisor) / Tran, Alisia (Thesis advisor) / Bludworth, James (Committee member) / Arizona State University (Publisher)
Created2018