Help-Seeking Stigma in Asian American College Women: the Role of Disordered Eating Cognitions and Psychological Inflexibility

Factors associated with intentions to seek formal and informal mental health help among college students with suicidal thoughts and behaviors

OBJECTIVE

Identify factors associated with formal and informal mental health help-seeking intentions among college students reporting suicidal thoughts and behaviors (STBs).

PARTICIPANTS

College students with STBs in the 2018-2020 Healthy Minds Study.

METHODS

Cross-sectional secondary analysis using logistic regressions to determine whether demographic (age, sex, race, religion, and finances) and psychosocial factors (mental health, perceptions about mental health help, and barriers) are associated with (in)formal help-seeking intentions.

RESULTS

Positive significant factors for all help-seeking intentions included being in a romantic relationship, Christian, symptoms of anxiety, or positive beliefs and knowledge about therapy efficacy. Depressive symptoms, Black/African American, psychological inflexibility, low perceived need, and barriers were negatively associated. Informal help-seeking was negatively associated with Hispanic/Latinx and personal stigma toward mental health. Formal help-seeking was positively associated with Asian/Asian American and negatively associated with financial stress.

CONCLUSIONS

Unique factors were associated with formal or informal help-seeking intentions in college students with STBs.

Ethnic Differences in Response to COVID-19: A Study of American-Asian and Non-Asian College Students

Asian American students have experienced additional physical and emotional hardships associated with the COVID-19 pandemic due to increased xenophobic and anti-Asian discrimination. This study investigates different coping patterns and risk factors affecting Asian and non-Asian college students in response to COVID-19 challenges by studying the differences in their responses within four domains after the onset of the pandemic: academic adjustment, emotional adjustment, social support, and discriminatory impacts related to COVID-19. We first employed a machine learning approach to identify well-adjusted and poorly adjusted students in each of the four domains for the Asian and non-Asian groups, respectively. Next, we applied the SHAP method to study the principal risk factors associated with each classification task and analyzed the differences between the two groups. We based our study on a proprietary survey dataset collected from U.S. college students during the initial peak of the pandemic. Our findings provide insights into the risk factors and their directional impact affecting Asian and non-Asian students' well-being during the pandemic. The results could help universities establish customized strategies to support these two groups of students in this era of uncertainty. Applications for international communities are discussed.

Not All the Same: Examining Asian American Women’s Self-Objectification Processes Using a Latent Class and Cultural-Specific Approach

Past research has shown that Asian American women are subject to distinct forms of sexism and racism that can influence culture-specific appearance evaluations. However, no studies have examined within-group differences in self-objectification processes. To address this gap, we used latent class analysis. Our study had three aims: (a) identify subgroups (e.g., latent classes) of Asian American women ( N = 554) based upon their general and group-specific self-objectification processes, (b) examine the racial objectification predictors (e.g., general racism, gendered racial microaggressions, and racial identity) of latent class membership, and (c) examine the relation between the classes and disordered eating and depression. Results of the latent class analysis yielded four classes: (a) High Self-Objectification class (37.2%), (b) Moderate Self-Objectification class (40.1%), (c) Body Conscious class (7.3%), and (d) Appearance Acceptance class (15.5%). The High Self-Objectification class reported significantly higher rates of disordered eating and depression. Women were more likely to be in the High Self-Objectification class if they experienced higher levels of gendered racial microaggressions and racial dissonance. Results can advance the literature by demonstrating significant within-group variability in self-objectification processes among Asian American Women and offer valuable clinical implications for targeting high-risk groups.

Help-seeking attitudes and behaviours among youth with eating disorders: a scoping review

BACKGROUND

Although early intervention is crucial in interrupting the development of eating disorders, little is currently known about help-seeking behaviours among individuals experiencing eating disorder symptoms. Given that eating disorders typically begin early in life, it is necessary to investigate the processes employed by children, adolescents, and emerging adults when seeking services for troubling symptoms. This is a growing concern as the COVID-19 pandemic has resulted in an increase in the number of individuals engaging in disordered eating behaviours. This scoping review explores the current state of the literature for evidence on how youth with eating disorder symptoms seek help, with the aim of better understanding how to identify and treat more individuals earlier.

METHODS

Using scoping review methodology, we searched seven databases for studies published from January 2000 to April 2021 that reported on help-seeking attitudes, behaviours, and healthcare utilization patterns for children and adolescents (< 18 years), emerging adults (18-25 years), and a mixture of these groups (< 25 years). Seven thousand, two hundred, and eighteen articles were identified for review. After duplicates were removed, three reviewers independently screened titles and abstracts and reviewed full-text articles. Findings related to help-seeking activity were extracted from the 62 articles that were ultimately included in this scoping review.

RESULTS

Study findings were summarized into help-seeking patterns (i.e., rates, types) as well as factors ranging from the individual level to society that influenced help-seeking behaviour. Many youth meeting eating disorder criteria were not seeking help. Notable barriers to help-seeking included poor mental health literacy, experiences with healthcare providers who failed to detect and lacked knowledge about eating disorders, minimal support from family and friends, and stigma surrounding eating disorders and help-seeking for mental health concerns.

CONCLUSIONS

The results of this scoping review can be used to inform early intervention and health promotion program development. Future research should focus on the help-seeking attitudes and activities among underrepresented groups with eating disorders (e.g., men, ethnic and gender minorities), the perspectives of family and other supporters in the help-seeking process for youth, and retrospective accounts from adults with lived experience of an eating disorder. Plain English summary Addressing and interrupting eating disorder-related thoughts and behaviours as soon as possible, with the help of a mental health professional, leads to better outcomes for youth struggling with an eating disorder. However, little is known about what prompts youth to talk about their weight, body, or eating concerns with someone-like their parent, friend, teacher, guidance counsellor, or primary care practitioner. This review explores the available published research on help-seeking patterns and preferences among youth with eating disorder concerns. Our team followed a standardized process to find 62 relevant articles for this paper. Of note, many young people who reported eating disorder concerns were not seeking help for themselves. Feeling supported by family and their primary care provider, understanding the signs of an eating disorder, and not feeling shame for reaching out for help reportedly led youth to speak up about their concerns. The findings have clinical implications for learning effective ways to help youth feel safe to speak freely about their eating disorder-related concerns, which enhances the chances of intervening early and catching symptoms before they worsen.

United States Air Force Academy Cadets' Perceived Costs of Concussion Disclosure

INTRODUCTION

Concussion is unique among sport-related injuries as effective clinical diagnosis and treatment often rely on symptom-report for clinician diagnosis and treatment. However, at-risk populations such as collegiate athletes and military academy cadets often have been shown to under-report concussions and symptoms, complicating diagnosis, treatment, and policy-based interventions. The purpose of this study was to explore factors influencing concussion reporting in United States Air Force Academy (USAFA) cadets.

MATERIALS AND METHODS

Semi-structured interviews were conducted on 34 cadets (18 with concussion history; 16 without concussion history). This study was approved by the USAFA Institutional Review Board. Analysis included a five-cycle process of clarifying the topic at hand through an introduction, conducting a literature review, data collection and summarization, relating current findings to current literature, and making final interpretations. Data were summarized by creation of a codebook after reading five transcripts and identifying meaningful units. A four-person research team read and identified meaningful units individually, then met to discuss common meaningful units and codebook creation. Once the codebook was created, the lead researcher used the codebook to code all transcripts.

RESULTS

Eight themes were generated from interview transcripts. This manuscript focuses on the perceived costs following a concussion theme and the following subthemes: perceived costs to physical fitness, military career aspirations, pilot qualifications, sport, reputation, academics, and lack of time.

CONCLUSIONS

Cadet interviews described a complex environment where concussions were often viewed as costly to future career ambitions and provided potential reasons for non-disclosure largely including disruption in daily life. Reduction in perceived and actual harms due to concussion disclosure will require not only improving clinical care, but also addressing barriers to self-disclosure. Additionally, research suggests the sooner one reports a concussion, the sooner they return to physical or military activity. Educational interventions should be designed to address the perceived costs identified from our study and educate cadets that while some costs may be reality, others may not. Secondly, it should also be stressed to cadets that the sooner one seeks medical attention following a concussion, the sooner they may return to activity. Messaging around these themes may decrease the costs associated with time removed from academics, athletics, or military activities therefore minimizing attempts at concussion self-management. Lastly, if efforts are made to improve the overall concussion disclosure stigma, cadets may increase seeking care after injury because their reputation may not be as impacted.

Mindfulness as a Moderator of the Association Between Eating Disorder Cognition and Eating Disorder Behavior Among a Non-clinical Sample of Female College Students: A Role of Ethnicity

The present cross-sectional study examined whether mindfulness moderated the association between eating disorder cognition and eating disorder behaviors among Asian American, Black American, and White American female college students in the United States. Participants (N = 463, age range = 18–25 years) completed self-report measures online. Results revealed that mindfulness moderated the association between eating disorder cognition and eating disorder behavior in the White American group, but not in Asian American or Black American samples. Future research should replicate these differential findings across ethnic groups and investigate the factors that may contribute to this group difference.