Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking.

Abstract

The Strong Black Woman (SBW) race-gender schema prompts African American women to use self-reliance and self-silence as coping strategies in response to stressors. Utilizing the coping strategies associated with the SBW race-gender schema could trigger anxiety and depression symptoms that may intensify when coupled with negative attitudes toward professional psychological help. The present study investigated whether African American women's endorsement of the SBW race-gender schema predicted increased symptoms of anxiety and depression and whether attitudes toward professional psychological help-seeking intensified psychological distress. Data were collected from 95 participants ranging in age from 18 to 65. Hierarchical regression analysis demonstrated significant main effects for the SBW race-gender schema and greater anxiety and depression, respectively. Greater indifference to stigma, 1 dimension of help-seeking attitudes, predicted lower levels of anxiety. African American women's attitudes toward professional help-seeking did not moderate the associations between endorsement of the SBW race-gender schema and anxiety or depression, respectively. Finally, endorsement of the SBW race-gender schema was inversely and significantly associated with 2 facets of help-seeking attitudes: (a) psychological openness and (b) help-seeking propensity. Taken together, these findings provide empirical support for the role of cultural factors, like the SBW race-gender schema, in African American women's experience of psychological distress and potential underutilization of mental health services. Future research directions are discussed. (PsycINFO Database Record

Investigating institutional abuse survivors’ help-seeking attitudes with the Inventory of Attitudes towards Seeking Mental Health Services

“…The current sample was characterized by significantly higher levels in IASMHS scales compared to most of these distressed samples (Mesidor & Sly, 2014; Troeung et al, 2015; Watson & Hunter, 2015). However, a sample of suicide-bereaved adults reported higher levels in the help-seeking propensity and the full IASMHS scale (Drapeau et al, 2016).…”

“…PO = Psychological openness, HSP = Help seeking propensity, IS = Indifference to stigma; a Watson and Hunter (2015): N  = 95, African American women with possible anxiety/depression symptoms; b Drapeau et al (2016): N  = 418, suicide-bereaved adults; PO subscale was excluded due to low internal consistency (α = 0.68); c Mesidor and Sly (2014): N  = 111, African American College Students with possible psychological distress; d Troeung et al (2015): N  = 327, Australian adults with Parkinson’s Disease and possible mental health problems; e t -tests comparing study sample to previous research samples; * p  < .05; ** p  < .01; *** p  < 0.001.…”

“…The help-seeking propensity scale frequently showed higher levels than the psychological openness scale, whereas the indifference to stigma subscale showed the lowest levels among the scales. However, the absolute scale-levels differed significantly between samples: African Americans and adults with Parkinson’s Disease showed lower scores in IASMHS scales (Mesidor & Sly, 2014; Troeung et al, 2015; Watson & Hunter, 2015). Only suicide bereaved adults reported significantly higher scores in two of the three scales compared to the institutional abuse sample (Drapeau et al, 2016).…”

“…IASMHS has been used to investigate attitudes in college students (Mackenzie et al, 2004; Mojaverian, Hashimoto, & Kim, 2012; Wahto & Swift, 2016; Yousaf, Popat, & Hunter, 2015), adolescents (Munson, Floersch, & Townsend, 2010), older adults (Kessler, Agines, & Bowen, 2014), psychotherapy clients (Elkins, Swift, & Campbell, 2016), and specific ethnic groups: Alaska natives (Freitas-Murrell & Swift, 2015), South Asians (Loya, Reddy, & Hinshaw, 2010), Chinese immigrants (Tieu & Konnert, 2014), and African Americans (Ward et al, 2013; Watson & Hunter, 2015). Only a few studies screened for mental disorders (Mackenzie et al, 2006; Mesidor & Sly, 2014; Munson et al, 2010; Troeung, Gasson, & Egan, 2015; Ward et al, 2013; Watson & Hunter, 2015) and intentions to (or actual) mental health service use (Freitas-Murrell & Swift, 2015; James & Buttle, 2008; Martin & Howe, 2016; Tieu & Konnert, 2014).…”

“…Only a few studies screened for mental disorders (Mackenzie et al, 2006; Mesidor & Sly, 2014; Munson et al, 2010; Troeung, Gasson, & Egan, 2015; Ward et al, 2013; Watson & Hunter, 2015) and intentions to (or actual) mental health service use (Freitas-Murrell & Swift, 2015; James & Buttle, 2008; Martin & Howe, 2016; Tieu & Konnert, 2014). Two studies considered both mental disorders and intentions to/or actual mental health service use (Mackenzie et al, 2006; Mesidor & Sly, 2014).…”