A Content Analysis of Mental Health Discourse in Popular Rap Music.

Importance: Rap artists are among the most recognizable celebrities in the US, serving as role models to an increasingly diverse audience of listeners. Through their lyrics, these artists have the potential to shape mental health discourse and reduce stigma. Objective: To investigate the prevalence and nature of mental health themes in popular rap music amid a period of documented increases in mental health distress and suicide risk among young people in the US and young Black/African American male individuals in particular. Design and Setting: Lyric sheets from the 25 most popular rap songs in the US in 1998, 2003, 2008, 2013, and 2018, totaling 125 songs, were analyzed by 2 trained coders from March 1 to April 15, 2019, for references to anxiety, depression, suicide, metaphors suggesting mental health struggles, and stressors associated with mental health risk. Main Outcomes and Measures: Mental health references were identified and categorized based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) and Mayo Clinic definitions. Stressors included issues with authorities, environmental conditions, work, and love life. Descriptive language and trend analyses were used to examine changes over time in the proportion of songs with mental health references. Stressors were analyzed for their co-occurrence with mental health references. Results: Most of the 125 analyzed songs featured lead artists from North America (123 [98%]). Most lead artists were Black/African American male individuals (97 [78%]), and artists' mean (SD) age was 28.2 (4.5) years. Across the sample, 35 songs (28%) referenced anxiety; 28 (22%) referenced depression; 8 (6%) referenced suicide; and 26 (21%) used a mental health metaphor. Significant increases were found from 1998 to 2018 in the proportion of songs referencing suicide (0% to 12%), depression (16% to 32%), and mental health metaphors (8% to 44%). Stressors related to environmental conditions (adjusted odds ratio, 8.1; 95% CI, 2.1-32.0) and love life (adjusted odds ratio, 4.8; 95% CI, 1.3-18.1) were most likely to co-occur with lyrics referencing mental health. Conclusions and Relevance: References to mental health struggles have increased significantly in popular rap music from 1998 to 2018. Future research is needed to examine the potential positive and negative effects these increasingly prevalent messages may have in shaping mental health discourse and behavioral intentions for US youth.

How current and potential pre-exposure prophylaxis (PrEP) users experience, negotiate and manage stigma: disclosures and backstage processes in online discourse.

Research on stigma as a barrier to pre-exposure prophylaxis (PrEP) uptake for reducing risk of HIV infection has focused on the experience of stigma-othering, shaming and blaming and the associated negative social consequences of this stigmatisation. This study expands this focus to examine how current and potential users of PrEP discuss their experiences of stigmatisation, in addition to their anticipation, preparation and management of stigmatising encounters. The corpus of testimonial blog posts from the "My PrEP Experience" website, reader comments on those posts, and information available through hyperlinks in the posts and comments, were subjected to a qualitative textual analysis. Findings revealed stigmatising labels and perceptions identified in other PrEP and HIV-related stigma research. Findings also revealed the active seeking and sharing of strategies for coping with and challenging stigma, including the creative re-appropriation of negative labels and calls for advocacy. The discussion considers how the described preparation and management strategies can inform future efforts to reduce stigma and encourage PrEP uptake.

Prevalence of Child-Directed Marketing on Breakfast Cereal Packages before and after Chile's Food Marketing Law: A Pre- and Post-Quantitative Content Analysis.

Food marketing has been identified as a contributing factor in childhood obesity, prompting global health organizations to recommend restrictions on unhealthy food marketing to children. Chile has responded to this recommendation with a restriction on child-directed marketing for products that exceed certain regulation-defined thresholds in sugars, saturated fats, sodium, or calories. Child-directed strategies are allowed for products that do not exceed these thresholds. To evaluate changes in marketing due to this restriction, we examined differences in the use of child-directed strategies on breakfast cereal packages that exceeded the defined thresholds vs. those that did not exceed the thresholds before (n = 168) and after (n = 153) the restriction was implemented. Photographs of cereal packages were taken from top supermarket chains in Santiago. Photographed cereals were classified as "high-in" if they exceeded any nutrient threshold described in the regulation. We found that the percentage of all cereal packages using child-directed strategies before implementation (36%) was significantly lower after implementation (21%), p < 0.05. This overall decrease is due to the decrease we found in the percentage of "high-in" cereals using child-directed strategies after implementation (43% before implementation, 15% after implementation), p < 0.05. In contrast, a greater percentage of packages that did not qualify as "high-in" used child-directed strategies after implementation (30%) compared with before implementation (8%), p < 0.05. The results suggest that the Chilean food marketing regulation can be effective at reducing the use of child-directed marketing for unhealthy food products.

Sad Kids, Sad Media? Applying Mood Management Theory to Depressed Adolescents' Use of Media.

Mood management studies typically have found that adults will select media that enhance positive moods and reduce negative moods. In this study, adolescents diagnosed with major depressive disorder and control adolescents without psychiatric disorders were called on customized cell phones up to 4 times a day and asked about their current mood state and media use for five extended weekends across an 8-week period. Mood effects on subsequent media use, mood during media consumption, and media effects on subsequent mood were examined. Results indicated that adolescents who consumed fun media tended to do so in a way that sustained, rather than enhanced their prior positive mood levels during and after consumption-if they turned to media. Adolescents in more negative moods did not often use media to improve their moods. When they did, boys were more likely than girls to use media that ultimately reduced negative mood levels. Findings are discussed in light of the literature on mood management, adolescence, and depression.