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Van Doren N, Zhu Y, Vázquez MM, Shah J, Grammer AC, Fitzsimmons-Craft EE, Eisenberg D, Wilfley DE, Taylor CB, Newman MG. Racial and Ethnic Disparities in Barriers to Mental Health Treatment Among U.S. College Students. Psychiatr Serv 2024:appips20230185. [PMID: 38807580 DOI: 10.1176/appi.ps.20230185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Using a sample of U.S. college students, the authors evaluated whether barriers to mental health treatment varied by race and ethnicity. METHODS Data were drawn from a large multicampus study conducted across 26 U.S. colleges and universities. The sample (N=5,841) included students who screened positive for at least one mental disorder and who were not currently receiving psychotherapy. RESULTS The most prevalent barriers to treatment across the sample were a preference to deal with issues on one's own, lack of time, and financial difficulties. Black and Hispanic/Latine students reported a greater willingness to seek treatment than did White students. However, Black and Hispanic/Latine students faced more financial barriers to treatment, and Hispanic/Latine students also reported lower perceived importance of mental health. Asian American students also reported financial barriers and preferred to handle their issues on their own or with support from family or friends and had lower readiness, willingness, and intentionality to seek help than did White students. CONCLUSIONS Disparities in unmet treatment needs may arise from both distinct and common barriers and point to the potential benefits of tailored interventions to address the specific needs of students of color from various racial and ethnic backgrounds. The findings further underscore the pressing need for low-cost and brief treatment models that can be used or accessed independently to address the most prevalent barriers for students.
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Affiliation(s)
- Natalia Van Doren
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Yiqin Zhu
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Melissa M Vázquez
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Jillian Shah
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Anne Claire Grammer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Daniel Eisenberg
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Denise E Wilfley
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Craig Barr Taylor
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
| | - Michelle G Newman
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Van Doren); Departments of Psychological and Brain Sciences (Zhu, Fitzsimmons-Craft) and Psychiatry (Vázquez, Shah, Grammer, Fitzsimmons-Craft, Wilfley), Washington University in St. Louis, St. Louis; Department of Health Policy and Management, University of California, Los Angeles, Los Angeles (Eisenberg); Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford; Center for mHealth, Palo Alto University, Palo Alto, California (Taylor); Department of Psychology and Psychiatry, Pennsylvania State University, University Park (Newman)
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Moradi S, Fateh MS, Movahed E, Mortezagholi B, Amini MJ, Salehi SA, Hajishah H, Nowruzi M, Shafiee A. The prevalence of depression, anxiety, and sleep disorder among dental students: A systematic review and meta-analysis. J Dent Educ 2024. [PMID: 38504501 DOI: 10.1002/jdd.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/21/2024] [Accepted: 02/06/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Despite the increasing concern, the literature lacks a comprehensive synthesis of the prevalence of depression, anxiety, and sleep disturbances among dental students. METHODS We conducted a systematic review following Cochrane Manual for Systematic Reviews of Interventions and PRISMA guidelines. Our search, spanning databases like Medline, Web of Science, and Scopus, covered data until June 5, 2023. A random effect model was utilized for the meta-analysis. RESULTS From 508 initially identified articles, 45 studies met eligibility criteria. The pooled prevalence of depression, anxiety, and sleep disorders among dental students was estimated as follows: depression [38%, 95% confidence interval (CI): 32%-44%; I2 = 98%], anxiety [48%, 95% CI: 41%-55%; I2 = 97.7%], and sleep disorders [31%, 95% CI: 24%-38%; I2 = 85.7%]. Subgroup analyses based on geographical regions and assessment scales revealed significant between-subgroup differences. Meta-regression identified associations between the prevalence of depression and the year of publication and between the prevalence of anxiety and total sample size, participant age, and year of publication. Publication bias assessments demonstrated a lack of significant bias, strengthening the validity of the findings. CONCLUSIONS The prevalence of depression, anxiety, and sleep disturbances in dental students is significant. This study highlighted the need for targeted interventions and support systems within dental education to alleviate the mental health challenges students face, ultimately ensuring their well-being and competence as future healthcare providers. Further research should explore the effectiveness of interventions in this population.
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Affiliation(s)
- Shayan Moradi
- Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Fateh
- Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Emad Movahed
- Dental Research Center, Faculty of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Bardia Mortezagholi
- Dental Research Center, Faculty of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Amini
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hamed Hajishah
- School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Mahdi Nowruzi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Arman Shafiee
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran
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La Scala S, Mullins JL, Firat RB, Michalska KJ. Equity, diversity, and inclusion in developmental neuroscience: Practical lessons from community-based participatory research. Front Integr Neurosci 2023; 16:1007249. [PMID: 37007188 PMCID: PMC10060815 DOI: 10.3389/fnint.2022.1007249] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/24/2022] [Indexed: 03/18/2023] Open
Abstract
Exclusion of racialized minorities in neuroscience directly harms communities and potentially leads to biased prevention and intervention approaches. As magnetic resonance imaging (MRI) and other neuroscientific techniques offer progressive insights into the neurobiological underpinnings of mental health research agendas, it is incumbent on us as researchers to pay careful attention to issues of diversity and representation as they apply in neuroscience research. Discussions around these issues are based largely on scholarly expert opinion without actually involving the community under study. In contrast, community-engaged approaches, specifically Community-Based Participatory Research (CBPR), actively involve the population of interest in the research process and require collaboration and trust between community partners and researchers. This paper outlines a community-engaged neuroscience approach for the development of our developmental neuroscience study on mental health outcomes in preadolescent Latina youth. We focus on “positionality” (the multiple social positions researchers and the community members hold) and “reflexivity” (the ways these positions affect the research process) as conceptual tools from social sciences and humanities. We propose that integrating two unique tools: a positionality map and Community Advisory Board (CAB) into a CBPR framework can counter the biases in human neuroscience research by making often invisible–or taken-for-granted power dynamics visible and bolstering equitable participation of diverse communities in scientific research. We discuss the benefits and challenges of incorporating a CBPR method in neuroscience research with an illustrative example of a CAB from our lab, and highlight key generalizable considerations in research design, implementation, and dissemination that we hope are useful for scholars wishing to take similar approaches.
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Affiliation(s)
- Shayna La Scala
- Department of Sociology, University of California, Riverside, Riverside, CA, United States
| | - Jordan L. Mullins
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Rengin B. Firat
- Department of Sociology, University of California, Riverside, Riverside, CA, United States
- Korn Ferry Institute, Los Angeles, CA, United States
| | | | - Kalina J. Michalska
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
- *Correspondence: Kalina J. Michalska,
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Mullins JL, Zhou E, Michalska KJ. How Parental Support Affects Latina Girls During the COVID-19 Pandemic. SOCIAL PSYCHOLOGY 2023. [DOI: 10.1027/1864-9335/a000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract. The current study focuses on a sample of low- to middle-income school-age Latina girls and their parents and examines how children’s distress proneness interacts with parental empathic accuracy and posttraumatic growth in the wake of the COVID-19 pandemic to predict children’s empathy and prosocial behavior toward unknown others. Approximately 2–3 months into state-mandated stay-at-home orders, 55 parent–daughter dyads were recruited to participate in this four-session longitudinal study. To assess distress proneness, daughters (ages 8–13 years, 100% Latina) identified their degree of distress in response to pandemic-related stressors. Concurrently, their parents reported how they thought their children would respond to these same pandemic-related stressors, which assessed parental empathic accuracy. Parents also completed an adapted version of the Posttraumatic Growth Inventory, which assessed perceived positive outcomes of the COVID-19 pandemic. Upon study completion, a behavioral measure of children’s empathic and prosocial behaviors was collected. Parental empathic accuracy interacted with children’s distress proneness to positively predict children’s affective empathy, such that children’s distress proneness predicted affective empathy at high and mean, but not low, levels of parental empathic accuracy. In a separate analysis, parental posttraumatic growth interacted with children’s distress proneness to positively predict children’s altruistic sharing behavior, such that children’s distress proneness predicted altruistic sharing behavior only at high, but not mean or low, levels of parental posttraumatic growth. The results of this study highlight how positive parental socialization and understanding of children’s tendencies toward distress are associated with children’s empathic and prosocial behaviors, particularly during major global crises.
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Affiliation(s)
- Jordan L. Mullins
- Department of Psychology, University of California, Riverside, CA, USA
| | - Elayne Zhou
- Department of Psychology, University of California, Riverside, CA, USA
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Glenn DE, Merenstein JL, Bennett IJ, Michalska KJ. Anxiety symptoms and puberty interactively predict lower cingulum microstructure in preadolescent Latina girls. Sci Rep 2022; 12:20755. [PMID: 36456602 PMCID: PMC9713745 DOI: 10.1038/s41598-022-24803-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Preadolescence is a period of increased vulnerability for anxiety, especially among Latina girls. Reduced microstructure (fractional anisotropy; FA) of white matter tracts between limbic and prefrontal regions may underlie regulatory impairments in anxiety. However, developmental research on the association between anxiety and white matter microstructure is mixed, possibly due to interactive influences with puberty. In a sample of 39 Latina girls (8-13 years), we tested whether pubertal stage moderated the association between parent- and child-reported anxiety symptoms and FA in the cingulum and uncinate fasciculus. Parent- but not child-reported anxiety symptoms predicted lower cingulum FA, and this effect was moderated by pubertal stage, such that this association was only significant for prepubertal girls. Neither anxiety nor pubertal stage predicted uncinate fasciculus FA. These findings suggest that anxiety is associated with disruptions in girls' cingulum white matter microstructure and that this relationship undergoes maturational changes during puberty.
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Affiliation(s)
- Dana E. Glenn
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
| | - Jenna L. Merenstein
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA ,grid.26009.3d0000 0004 1936 7961Brain Imaging and Analysis Center, Duke University, Durham, NC USA
| | - Ilana J. Bennett
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
| | - Kalina J. Michalska
- grid.266097.c0000 0001 2222 1582Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521 USA
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