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The present study examines how both between group (i.e., ethnic group membership) and within group cultural factors (i.e., nativity status, age of immigration, and perceived discrimination) may contribute to anxiety and related symptoms in Latinx with anxiety disorders. Baseline data were examined from patients who participated in one of the largest intervention studies for adults with anxiety disorders in primary care settings; 196 Latinx and 568 NLW (non-Latinx White) patients participated. Proportions of anxiety disorders were similar between Latinx and NLWs; however, Latinx, on average, had a greater number of anxiety disorders than NLWs. Levels of anxiety and depression symptom severity, anxiety sensitivity, and mental functional impairment were similar between the ethnic groups. Latinx expressed greater somatization and physical functional impairment than NLWs. Among Latinx, perceived discrimination, but not other cultural variables, was predictive of mental health symptoms while controlling for age, gender, education, and poverty. Overall, these findings suggest more similarities than differences in types and levels of anxiety and anxiety-related impairment, with some important exceptions, including greater levels of somatization and physical functional impairment among Latinx patients. Further, perceived discrimination may be an important factor to consider when examining risk for greater symptom burden among Latinx with anxiety., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Parental variables likely have important and bidirectional influences on the etiology of child anxiety. Although some child-focused cognitive-behavioral therapy (CCBT) anxiety trials have found vicarious improvements among parents who participated in their children's treatment, this is an understudied area. We hypothesized that parental variables (psychopathology, stress, and burden) will significantly decrease from pre-to post-CCBT and will be associated with child treatment response. We explored whether intervention delivery method-in-person CCBT versus parent-mediated bibliotherapy-influenced vicarious parental improvements. Parental variables decreased from pre- to post-CCBT and were associated with child treatment response. Effects did not interact with delivery method. Parent participation in anxiety CCBT may result in vicarious improvements for parents.

IntroductionExternalizing disorders are more prevalent in rural than urban settings and account for disproportionately high mental health service costs for rural adolescents. Although cultural stressors such as discrimination have been associated with externalizing problems in ethnic minority youth broadly, this relationship is understudied in Latinos, particularly those in rural settings. Further, though the associations of family processes such as familism and family conflict have been studied in relation to youth externalizing symptoms, whether these processes change in the face of adolescent discrimination stress remains unknown.MethodsA moderated multiple mediation model was used to examine the association between perceived discrimination, externalizing symptoms, and the indirect effect of family factors (familism, and family conflict) in a large sample (n = 455) of rural Latino youth. We also evaluated whether indirect and direct effects of discrimination on externalizing symptoms differed in boys versus girls.ResultsFamilism and family conflict each independently mediated the relationship between discrimination related stress and externalizing symptoms. However, discrimination had a direct effect on externalizing symptoms for boys only. In girls, this association held only when family factors were accounted for. Post-hoc analyses reveal that the moderating effect of sex on discrimination is driven by differences in rule-breaking behavior, as opposed to aggressive behavior.ConclusionFindings suggest that discrimination is associated with changes in the family environment which in turn invoke elevated risk for externalizing problems. Further, family-focused interventions that address externalizing problems may be especially effective for adolescent girls.

The present study examines how both between group (i.e., ethnic group membership) and within group cultural factors (i.e., nativity status, age of immigration, and perceived discrimination) may contribute to anxiety and related symptoms in Latinx with anxiety disorders. Baseline data were examined from patients who participated in one of the largest intervention studies for adults with anxiety disorders in primary care settings; 196 Latinx and 568 NLW (non-Latinx White) patients participated. Proportions of anxiety disorders were similar between Latinx and NLWs; however, Latinx, on average, had a greater number of anxiety disorders than NLWs. Levels of anxiety and depression symptom severity, anxiety sensitivity, and mental functional impairment were similar between the ethnic groups. Latinx expressed greater somatization and physical functional impairment than NLWs. Among Latinx, perceived discrimination, but not other cultural variables, was predictive of mental health symptoms while controlling for age, gender, education, and poverty. Overall, these findings suggest more similarities than differences in types and levels of anxiety and anxiety-related impairment, with some important exceptions, including greater levels of somatization and physical functional impairment among Latinx patients. Further, perceived discrimination may be an important factor to consider when examining risk for greater symptom burden among Latinx with anxiety.

BackgroundStigma has been frequently cited as a barrier to service use for various mental health problems. Studies suggest that stigma may be greater for childhood mental health problems that are perceived as more atypical.AimsThis study utilized a mixed methods research design (qual + QUAN) to examine parental endorsement of stigma and its impact on service utilization among children with significant anxiety-a common childhood problem frequently perceived as normative.MethodsSemi-structured qualitative interviews were conducted with 29 parents of anxious children. Qualitative data were coded using a grounded theory approach, and stigma-related responses were examined for emergent themes. Quantitative data was analyzed with frequency counts and chi-square analysis.ResultsStigma related to children's anxiety symptoms and seeking mental health services was reported by 41.3% (n = 12) of parents. Emergent themes included: 1) Parental Concern for Negative Consequences, 2) Parent Internalized Stigma, and 3) Negative Associations with Mental Health Treatment. Latino parents discussed stigma more frequently than non-Latino White parents (70% vs. 17.6%, respectively, X2(1, N = 27) = 5.33, p < 0.05).ConclusionsAlthough anxiety is a common childhood problem, stigma is still frequently reported by parents and may be an important barrier to mental health service use, especially among Latino youth.

Previous research suggests that rural Latinx youth are more likely to experience traumatic events and are at higher risk for developing subsequent psychopathology compared to non-Latinx white youth. The aim of this study is to understand how family processes and values affect risk for internalizing and externalizing symptoms among rural Latinx youth (N = 648, mage = 15.7 (SD = 1.2)) who are exposed to trauma. Multiple mediation analyses were performed to understand if family variables such as familism and family conflict explain the relationship between trauma exposure and psychopathology. Results suggest that familism partially mediates the relationship between trauma exposure and internalizing and externalizing symptoms, whereas family conflict partially mediates the relationship between trauma exposure and externalizing symptoms. These findings show that family variables are differentially impacted by trauma and have a separate and unique impact on mental health outcomes among rural Latinx youth. Specifically, our findings suggest that familial support or closeness may constitute a nonspecific protective factor for psychopathology among Latinx youth, whereas family conflict creates a stressful home environment that may deter adolescent trauma recovery and lead specifically to externalizing symptoms. [ABSTRACT FROM AUTHOR]

• Experiences of discrimination affect rural Latinx adolescents' peer and family domains. • Spillover effects among these domains are associated with increases in internalizing symptoms. • Age emerged as a significant moderator of this serial mediation model. There is a well-documented relationship between perceived discrimination and internalizing symptoms among Latinx adolescents. However, few studies have examined how this psychosocial stressor relates to multiple domains of functioning in rural Latinx adolescents simultaneously. This study tested a spillover model of internalizing symptom development, where the negative effects of perceived discrimination are experienced through peer and family relationships. Rural Latinx adolescents (n = 639; M age = 15.62, SD age = 1.09; 53% female) provided information on social, familial, and individual risk and resilience factors that affect adolescents' mental health. A serial mediation model was conducted using structural equation modeling. Exploratory analyses examined whether these effects varied based on adolescents' age, gender, and acculturation level. Perceived discrimination was significantly associated with peer victimization. In turn, higher peer victimization was significantly associated with lower familism, where higher familism was significantly associated with lower internalizing symptoms. The serial indirect effect (i.e., perceived discrimination → peer victimization → familism → internalizing symptoms) was statistically significant, indicating a pathway through which perceived discrimination affects peer and family domains of functioning. Age emerged as a significant moderator of the indirect effect specifically by moderating the discrimination → peer victimization path. The results are consistent with a spillover model where perceived discrimination increases risk for peer victimization, which in turn erodes protective family-oriented values such as familism, especially among older adolescents. These findings highlight a potential etiological model by which experiences of discrimination may lead to the development of internalizing symptomatology. [ABSTRACT FROM AUTHOR]