Rural US residents recognize anxiety better than urbanites and suburbanites but hold similar stigma.

PURPOSE: Recognizing signs of psychological distress is a critical first step in assisting people who are struggling with poor mental health to access help. However, community-level factors that impact recognition and stigma are underexplored. The purpose of this study is to investigate the relationship between rurality, other community-level variables, and individual variables with regard to the recognition and stigma of anxiety. METHODS: We use a survey of US adults (N = 627), including a rural oversample, and a cloaked vignette approach. We assess the ability to identify anxiety and measure associated stigma. The analysis applies an ecological model in multinomial logistic regressions. FINDINGS: About half of the respondents recognize anxiety from a list of possibilities when provided with a vignette detailing common anxiety symptoms. Respondents living in rural areas are nearly twice as likely to correctly identify anxiety than nonrural respondents. About one-fifth of respondents agree with a statement designed to measure stigma: that exhibiting the symptoms is a sign of personal weakness. Respondents able to identify anxiety show less stigma. Respondents from counties with high mental health provider access were less likely to endorse the stigma statement. CONCLUSIONS: Rural areas seem poised to reduce the stigma associated with anxiety, because residents are more adept at identifying anxiety than people living elsewhere. Future work could focus on effective mechanisms for reducing stigma associated with anxiety in rural areas, and whether anxiety recognition and stigma are changing.

Social Status Influence on Stigma Towards Mental Illness and Substance Use Disorder in the United States.

We describe the relationship between socio-demographic membership and stigma towards any mental illness (AMI) and substance use disorder (SUD) in the United States using a national survey (N = 2512). We hypothesize that participants from higher status socio-demographic groups may be more likely to report stigmatizing attitudes than participants from lower status socio-demographic groups. We find support for our hypothesis using multiple linear regression. Participants who were college-educated, male, or had household incomes above the national median were more likely to report stigmatizing attitudes toward both AMI and SUD in comparison to participants that were not college-educated, were female, or had household incomes below the national median. In contrast to our hypothesis, we find that participants who identified as Hispanic were more likely to report stigmatizing attitudes toward AMI than non-Hispanic whites. Younger and urban participants were more likely to report stigmatizing attitudes than their older and non-urban counterparts.

Uncovering Profiles of Economic, Social, and Cultural Capital to Explore Depression Across Racial Groups.

Research exploring the association between socio-economic status (SES) and depression is limited by conceptualizations of SES and conflicting findings across racial groups. We broaden previous research by (1) reconceptualizing SES through the lens of Bourdieusian theory to identify profiles of economic, social, and cultural capital; (2) investigating whether these profiles differ for Black and white adults; and (3) exploring whether specific profiles of capital are associated with increased depression scores. This study analyzed secondary data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of US individuals. A sub-population of the sample was used, which was comprised of 4339 Black and white participants from wave IV. To address the study aims, we used the new three-step approach to conducting latent class analysis. We identified five profiles of capital, the composition of which varied by race. Compared to Blacks, whites were more likely to be in the "cultural-economic capital" (14% vs. 10%), "elevated overall capital" (35% vs. 14%), and "social-economic capital" (13% vs. 10%) profiles, whereas Blacks were more likely to be in the "limited overall capital" (35% vs. 16%) and "moderate economic capital" (32% vs 22%) profiles. Profiles differed in risk for depression; the "limited overall capital" profile had the highest depression scores, whereas the "elevated overall capital" profile had the lowest depression scores. This research has the potential to reduce health disparities, by providing policy makers and researchers with information that will allow them to target populations that are most at risk for depression.

Racial-ethnic differences in sexual risk behaviors: The role of substance use.

This research investigates the impact adolescent substance use has on adult sexual risk behaviors within racial-ethnic groups. Previous research has found support for this relationship, but often relies on concurrent measures of substance use and sexual risk behavior meaning that the causal direction of this relationship may be unclear. The data for this study come from the National Longitudinal Survey of Adolescent to Adult Health (Add Health), a nationally representative survey that followed respondents from adolescence in 1994 to adulthood in 2008. Results show that substance use correlates with sexual risk behavior, but the impact varies by race-ethnicity.

Race-Ethnicity and Prescription Drug Misuse: Does Self-esteem Matter?

The research here investigates race-ethnicity and self-esteem in the misuse of prescription drugs. While there has been much research into the demographic factors that predict prescription drug misuse (PDM), we lack a full accounting of psychosocial factors of possible importance in influencing patterns of race-ethnicity and PDM. One possible influence is self-esteem. We use data from the National Longitudinal Survey on Adolescent Health to investigate race-ethnicity, PDM and self-esteem. Findings indicate first that race-ethnicity is significant is PDM. Secondly, results indicate that self-esteem is important in understanding patterns of prescription drug misuse among young adults, but only among whites.