Hsiu-Lan Cheng

Racial and Ethnic Minority College Students' Stigma Associated With Seeking Psychological Help: Examining Psychocultural Correlates

Many college students underuse professional psychological help for mental health difficulties. The stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of psychological distress and past use of counseling/psychotherapy have been found to be important correlates of stigma associated with seeking psychological help (Obasi & Leong, 2009; Vogel, Wade, & Haake, 2006). For racial and ethnic minorities, the hindering effects of self-stigma and perceived stigmatization by others on treatment seeking may further be compounded by their relationships with their own ethnic groups, with other ethnic groups, and with the dominant society. This study used structural equation modeling (SEM) to test a model that explored the effects of psychological distress and psychocultural variables (i.e., ethnic identity, other-group orientation, perceived discrimination) on perceived stigmatization by others and self-stigma for seeking psychological help, controlling for past use of counseling/psychotherapy. The sample consisted of 260 African American, 166 Asian American, and 183 Latino American students. SEM multigroup analyses indicated measurement invariance, but partial structural invariance, across racial/ethnic groups. Across all 3 groups, higher levels of psychological distress and perceived racial/ethnic discrimination, respectively, predicted higher levels of perceived stigmatization by others for seeking psychological help, which, in turn, predicted greater self-stigma for seeking psychological help. Higher levels of other-group orientation predicted lower levels of self-stigma of seeking psychological help across groups. Higher levels of ethnic identity predicted lower levels of self-stigma of seeking psychological help only for African Americans. Implications for research and practice are discussed.

Developing a screening instrument and at-risk profile for nonsuicidal self-injurious behavior in college women and men.

Archival data (N = 1,048 women, 1,136 men) from a mental health survey of college students were used to investigate incidence of nonsuicidal self-injury (NSSI), including cutting. Significant levels (defined as 4-5 lifetime incidents) were found in 9.3% of women and 5.3% of men. The Counseling Center Assessment for Psychological Symptoms (a global symptom inventory) and an assessment of trauma had been field tested with this sample. We randomly partitioned half of these data into a holdout sample and used the remainder to develop an NSSI screening inventory that included (a) 5 womens screening items, including 1 item to assess trauma experienced; (b) 11 mens screening items; and (c) 12 items common to men and women, including depression, dissociation, anger, unwanted thoughts, nightmares or flashbacks, and having witnessed trauma. Logistic regression and receiver-operating characteristic curve analysis suggested the inventory significantly discriminated NSSI men and women in the holdout sample, p < .001. Cutoff scores were identified to correctly classify about 48% of the true positive male and female NSSI cases, with false positive rates of 13.2% and 8.4% for women and men, respectively.

Racial/ethnic discrimination, posttraumatic stress symptoms, and alcohol problems in a longitudinal study of Hispanic/Latino college students

Racial/ethnic discrimination has been identified as a risk factor in the development of posttraumatic stress disorder (PTSD) symptoms in persons of color (Carter, 2007). Many persons, regardless of race/ethnicity, with PTSD symptoms resulting from combat, violent crimes, sexual assault, or natural disasters use alcohol in an attempt to cope. This longitudinal study surveyed 203 Hispanic/Latino students twice at approximately a 1-year interval, and used a cross-lagged design to compare Time 1 links from alcohol use and experiences of discrimination with the same variables at Time 2, plus symptoms of PTSD. Each survey included the General Ethnic Discrimination scale and the Alcohol Use Disorders Identification Test. Only Time 2 packets contained the Posttraumatic Stress Disorder Checklist-Civilian. Cross-lagged analyses conducted by comparing nested structural equation models found that fixing the causal paths to zero from Time 1 experiences of discrimination to Time 2 alcohol problems and PTSD resulted in a significantly worse fit of the data. However, fixing the paths to zero from Time 1 maladaptive alcohol use to Time 2 PTSD and experiences of discrimination resulted in no significant difference in model fit. Thus, this pattern of findings is consistent with an inference that Hispanic/Latino college students who experience racial/ethnic discrimination are at risk for developing symptoms of posttraumatic stress and increased maladaptive alcohol use; conversely, maladaptive alcohol use does not appear to be a risk factor for later experiences of discrimination or PTSD symptoms.

Anger Expression Toward Parents and Depressive Symptoms Among Undergraduates in Taiwan

This study surveyed 559 Taiwanese undergraduates regarding anger expression toward parents and depressive symptoms. Five modes of anger expression were explored. All modes of expression were either neutral or positively associated with depressive symptoms. This result is contrary to studies of Western culture suggesting that some modes of anger expression may be beneficial. However, a significant buffering interaction effect was detected for women. Higher relative preference for outward verbal expression of anger (Verbal Out) was associated with fewer depressive symptoms at increasing levels of anger antecedents. For men, in contrast, greater preference for physical demonstrations of anger (Action Out) was associated with more depressive symptoms at increasing levels of anger antecedents. Implications of these findings for U.S. counselors serving clients with Taiwanese cultural values are discussed.

Disordered Eating Among Asian/Asian American Women: Racial and Cultural Factors as Correlates

Sociocultural models of eating disorders emphasize the role of internalization of media standards of beauty in eating pathology but rarely examine (a) how racial and cultural factors may be related to women of color’s tendency to endorse Western media beauty ideals or (b) these women’s risk of developing body dissatisfaction and disordered eating issues. This study of Asian/Asian American women (N = 587) investigated the roles of perceived racial discrimination, ethnic identity, and racial/ethnic teasing in relation to self-esteem, internalization of Western standards of beauty, and body dissatisfaction as predictors of disordered eating in a structural model. Results indicated that, when controlling for body mass, perceived racial discrimination, ethnic identity, and racial/ethnic teasing significantly predicted disordered eating and its correlate variables through direct and indirect links. The findings suggest racial and cultural factors may complement sociocultural models in understanding disordered eating issues among Asian/Asian American women.

Mental Health, Self-Stigma, and Help-Seeking Intentions Among Emerging Adults: An Attachment Perspective

Many college students experience common mental health concerns, such as anxiety and depression, but do not seek psychological help. The present study proposed an attachment theory–driven model interrelating adult attachment, mental health concerns, and self-stigma in predicting intentions to seek counseling with a college student sample (N = 1,682). Structural equation modeling revealed that attachment anxiety, but not attachment avoidance, directly and positively predicted intentions to seek counseling. However, mediation analyses indicated that attachment anxiety was also indirectly and negatively linked to help-seeking intentions through self-stigma. Specifically, higher levels of attachment anxiety, or the combination of attachment anxiety and mental health concerns, predicted greater levels of self-stigma, which in turn predicted weaker intentions to seek counseling. The findings point to the importance of considering the combined contributions of individual differences in attachment dimensions, levels of mental health concerns, self-stigma, and help-seeking intentions in understanding the help-seeking process.

Adult Attachment Dimensions and College Student Distress The Mediating Role of Hope

The present investigation examined dispositional hope as a psychological strength that mediates the associations between adult attachment dimensions and seven commonly assessed college student psychological symptoms, as measured by the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62): depression, eating concerns, substance use, generalized anxiety, hostility, social anxiety, and academic distress. Structural equation modeling of data obtained from students at a large Midwestern university (N = 2,644) revealed that (a) adult attachment dimensions were positively associated with CCAPS-62 domains and negatively associated with hope, (b) hope was negatively associated with all seven CCAPS-62 domains with the exception of substance use, and (c) hope mediated the associations between attachment dimensions and all seven CCAPS-62 psychological symptoms, with the exception of substance use. Findings suggest that addressing adult attachment-driven automatic views of self and others may have important implications for hopeful thinking as well as for counseling intervention and prevention of college student psychological distress.

Hope for Help-Seeking: A Positive Psychology Perspective of Psychological Help-Seeking Intentions ψ:

In the present study, we used multigroup structural equation modeling in a sample of college students (N = 2,461) to examine ethnic and gender differences in the connections between dispositonal hope and intentions to seek psychological help from formal and informal sources. In a personal-emotional problem scenario, we found a robust positive relationship between hope and intentions to seek help from informal sources, but no association for formal sources. In a suicidal thoughts scenario, hope was positively associated with intentions to seek both informal and formal psychological help. Results of exploratory moderation analyses indicated that the model was invariant across non-Latino White students and Asian American students, as well as across men and women. These findings address critical gaps in the hope and help-seeking literature, and suggest that increasing college students’ dispositional hope may provide a unique positive psychology-focused avenue for increasing help-seeking intentions, even within underserved populations.