<p dir="ltr">This dissertation includes two independent chapters which investigated the relations between upward social mobility (USM) and mental health in the United States. Chapter 1 was a systematized review which identified, cataloged, and synthesized the existing literature on the relations between USM and mental health in the United States. Four electronic databases were searched (i.e., PsycINFO, PubMed, Scopus, and Web of Science) and, through an exhaustive screening and data extraction process, a sample of 15 studies were reviewed. Chapter 1 used narrative synthesis (i.e., tabulation and thematic analysis) to describe and synthesize patterns across the existing literature. Notably, review findings revealed great variability in both research methodology used by studies as well as study findings. Moreover, review findings suggested that the variability observed among study findings was likely influenced by a lack of consistent operationalization of social mobility. Finally, recommendations for future research were provided.</p><p dir="ltr">Chapter 2 was an empirical study that examined moderators and mediators of the relations between USM and mental health. Based on the status-based identity framework (SBI; Destin et al., 2017), I hypothesized that USM would relate to poorer mental health, that belonging would mediate the relations between USM and mental health, and that internalized classism, interpersonal classism, and social class centrality would moderate the mediation. Data from a sample of 331 U.S. adults were collected via Prolific. While study results supported the first two hypotheses, only interpersonal classism was found to moderate the mediation. Specifically, the conditional indirect effect showed that those who experienced high and moderate levels of interpersonal classism had a negative relation between USM and belonging. Finally, study limitations and implications for research and clinical practice are discussed.</p>

Help-seeking has been studied for over 20 years, but much is yet to be known about what variables influence parental help-seeking. In the present studies, participants were recruited from Texas, Mississippi, and Louisiana. Study 1, included 260 caregivers recruited from local school districts and a church. Using confirmatory factor analysis, results supported the hypothesized 3-factor structure of the Parental Attitudes Toward Psychological Services Inventory (PATPSI) and internal consistency ranged from moderate to high. Study 2 conducted subsequent analyses on the data from Study 1. Correlation analyses supported the relationships among parental attitudes, stigma, and help-seeking. Secondly, parents with previous use of child mental health services reported more positive attitudes and less stigma than parents with no previous use. Thirdly, no significant gender differences were found, but there was a trend toward parents reporting higher intentions for boys than girls. Additionally, African Americans reported less positive attitudes and more stigma than the other ethnic groups. Finally, moderation analyses suggested that attitudes are more likely to influence help-seeking for European Americans but not for African Americans, and stigma appeared to influence helpseeking for Hispanic Americans but not for European Americans; no moderation effects were found for child gender. Finally, analyses indicated that only stigma and attitudes were significant independent predictors of help-seeking. Study 3 was a sub-sample from Study 1 (N = 118) who completed additional measures. The purpose was to replicate findings from Study 2 and examine test-retest reliability of the PATPSI. Test-retest reliability for the PATPSI was low in this sample. Overall, results were consistent with Study 2. Results indicated that parents with previous service use reported higher externalizing symptoms (not internalizing) than those with no previous use. Inconsistent with Study 2, Asian Americans reported less positive attitudes, and African Americans reported less stigma than European Americans and Asian Americans. Additionally, stigma tolerance was found to have a stronger influence on European Americans likelihood of future service use than for African Americans. Furthermore, the interaction between problem type and gender was not a significant predictor of likelihood of future use. Finally, only previous service use and attitudes (not stigma) were independent predictors of likelihood of future use. Implications for future research and practice are discussed.

Latinx, or Hispanic/Latino, minoritized groups experience a broad spectrum of mental health challenges, disparities, and risks at a disproportionate rate compared to both their non-White counterparts and compared to other minorized groups in the U.S. (SAMHSA, 2015). They also experience a number of cultural and individual strengths associated with their values, practices, and resiliencies (Leyva et al, 2022; Gennetian et al, 2021; Calzada et al, 2020). However, given the substantial percentage of Latinxs who live in the United States (18.7%), the mental health needs of this minoritized group are not sufficiently addressed in social science literature, as a number of systemic factors limit the inclusion of Latinxs in participant pools (Roberts et al, 2020; DeJesus et al, 2019). Across 13 high-impact journals and three clinical disciplines, a mere 2.5% of all scholarship published focused on Latinxs. Through qualitative content-analysis of key topics, methodology, funding sources, and sample characteristics across 20 years of literature (n = 7, 061), this paper seeks to highlight both the strengths and weaknesses of Latinx representation in the current literature with the hope to better prepare policy makers, program interventionists, and clinical practitioners to competently serve this marginalized population.

Barriers to Colorectal Cancer Screening in People Obtaining Care From Community Mental Health Agencies by Kelly Gardiner MSN, Wayne State University, 1997 BSN, Wayne State University, 1988 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2016 Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using the Health Belief Model, the proposed study investigated the effects of access to transportation, referral to screening, physical ability to complete the colonoscopy prep, type of procedure, awareness of the purpose of screening, anxiety, embarrassment, gender, race, and age to determine which affect completion of colorectal cancer screening. Significant relationships existed between embarrassment, fear of pain, fear of cancer, anxiety, physical ability to do testing, awareness of screening at age 50, FOBT vs Scope procedures, age of first screening, being told to get screening, knowing someone who had screening, and completion of colorectal cancer screening. In the binary logistic model Anxiety was negatively correlated and being told to get screening was positively correlated to completion of colorectal cancer screening and those choosing Scope were more likely to complete than those choosing FOBT. The results of this study may effect positive social change by providing healthcare providers with an increased understanding of variables that influence colorectal cancer screening completion among persons with a diagnosed mental illness, resulting in a changing agenda for effective mental and physical health care in this population.

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