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Abstract
Background
Mental health (MH) stigma is pervasive worldwide. Culturally sensitive stigma reduction programs are needed to reduce MH stigma.
Aims
To determine racial/ethnic and cultural predictors of stigma.
Method
The current study examined the relationship between cultural orientation (individualism-collectivism beliefs), race/ethnicity, and political beliefs (right-wing authoritarianism [RWA]). Participants (N = 951) from the United States completed an online survey for this cross-sectional study.
Results
Findings indicated that vertical individualism is a consistent, though modest, predictor of multiple dimensions of MH stigma, controlling for other predictors. Contrary to what was hypothesized, vertical individualism did not mediate the relationship between Asian-American race/ethnicity and MH stigma, but was found to mediate the relationship between RWA and stigma. A novel finding was that RWA mediated the relationship between African-American race/ethnicity and multiple MH stigma domains.
Conclusions
Findings therefore indicate that the endorsement of authoritarian views, rather than vertical-individualism (which advances the idea that everyone is in competition), is the primary mechanism of MH stigma differences between African-Americans and individuals from other racial/ethnic groups. A major implication from this study is that efforts to address MH stigma among specific cultural groups should incorporate a sensitivity to the role of both RWA and vertical individualism in facilitating stigma.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes
1 Study name: “Survey of Social Attitudes” (ethical approval reference #: 685279-1)
2 Higher scores on all scales are indicative of higher levels stigma.
3 In the first two models, race/ethnicity (Asian/Pacific Islander reference group) was included as a covariate; for the last model, vertical individualism was included as a covariate.
4 It should be noted that no other race/ethnicity groups (when dichotomized) were significantly correlated to vertical individualism. Thus, mediation was not explored for these racial/ethnic groups.
5 The goal of this model was to explore the total effects (c), direct effects (a, b), and effects when the mediator is held constant (c’) that indicated the unstandardized regression coefficients and significance between the independent and dependent variables (Díez-Fernández et al., Citation2018; Hayes, Citation2018). Indirect effects (a*b with 95% bootstrap confidence intervals) were then evaluated for evidence of mediation; these effects indicated the change in MH stigma for every unit change in RWA that is mediated by vertical individualism. Indirect effects were considered to be statistically significant when the confidence interval did not contain zero (Hayes, Citation2018; Hayes & Rockwood, Citation2017). This macro used bootstrapping methods (using a resample procedure of 5,000 bootstrap samples).
6 Modern mediation analysis “no longer imposes evidence of simple association between X and Y as precondition” (Hayes, Citation2018, p. 80; see also Hayes & Rockwood, Citation2017). Thus, indirect effects and confidence intervals not including 0 are reported below and are interpreted as statistically significant effects.
7 To support the validity of this relationship, other models were run with the other race/ethnicity groups dichotomized. A similar pattern of indirect effects was not found.