April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Racial Differences Among Asian and White American Emerging Adults With Mental Illnesses in Disclosure Strategy Selection to Friends
The prevalence of mental illnesses among college students is a growing concern (American College Health Association, 2021). Disclosing mental health information in close relationships, such as friendships, can lead to positive individual and relational health outcomes. Friendship development for emerging adults is an important component of the college experience, specifically as closer relationships increase chances of disclosure and maintains close ties (Derlega et al., 2004; Venetis et al., 2018)
Asian Americans are a particularly vulnerable population as mental illness rates are overall lower attributable to cultural stigma, underdiagnosis, and undertreatment (Jang et al., 2018). Given that only 16% of Asian Americans report a prevalence of mental illness compared to 24% of White Americans (SAMHSA, 2021), this group may have trouble sharing their mental health to personal networks thus impacting their chances to receive proper help. The cognitive processes of how disclosures occur to inform what strategies are utilized have gone unaccounted for in this literature space, warranting a deeper investigation.
The Disclosure Decision-Making Model (DD-MM; Greene, 2009) explains mechanisms of revealing non-visible health information. The DD-MM posits that people consider health information (stigma, preparation, prognosis, symptoms, and relevance to others), target recipients (relational closeness), and disclosure efficacy before pursuing a health-related disclosure. Disclosures take form via six strategies, namely directness, entrapment, incremental disclosures, indirect mediums, third-party disclosures, and preparation and rehearsal (Afifi & Steuber, 2009).
Guided by the DD-MM, the present study assessed racial differences in the associations between information assessment, recipient assessment (relational closeness and perceived support), self-efficacy, and disclosure strategies used between Asian American and White college students. Participants were 26 Asian American and 26 (randomly selected from 106) White American college students who disclosed their mental illness information to a friend. Participants completed electronic surveys that accessed DD-MM variables and disclosure strategies. We performed 12 linear regressions to determine DD-MM predictors per strategy per racial group. Due to small sample size, we conducted a zero-order correlation matrix to narrow predictor variables per strategy. The same predictors were included for both models (Asian and White) per strategy (ex. directness). Regressions revealed that predictors of Asian Americans’ disclosure strategies differ from White peers. Among Asian Americans, anticipated supportive response positively predicted one (directness, t = 2.22, p = .04) and negatively predicted four strategies (preparation and rehearsal, t = -4.65, p = .001; third party, t = -3.64, p = .001; entrapment, t = -3.04, p = .006; indirect mediums, t = -4.88, p = .001). Alternatively, supportive responses did not predict any disclosure strategies among White participants. Among White participants, preparation positively predicted four disclosure strategies (preparation and rehearsal, t = 2.01, p = .05; third party disclosure, t = 2.50, p = .02; entrapment, t = 2.71, p = .01; and indirect mediums, t = 4.33, p = .001). Results indicate minimal similarity in Asian American and White participants’ motivations for differing disclosure strategies when sharing mental health information with friends. Future research should continue to explore the unique motivators of disclosure among various college samples.
Asian Americans are a particularly vulnerable population as mental illness rates are overall lower attributable to cultural stigma, underdiagnosis, and undertreatment (Jang et al., 2018). Given that only 16% of Asian Americans report a prevalence of mental illness compared to 24% of White Americans (SAMHSA, 2021), this group may have trouble sharing their mental health to personal networks thus impacting their chances to receive proper help. The cognitive processes of how disclosures occur to inform what strategies are utilized have gone unaccounted for in this literature space, warranting a deeper investigation.
The Disclosure Decision-Making Model (DD-MM; Greene, 2009) explains mechanisms of revealing non-visible health information. The DD-MM posits that people consider health information (stigma, preparation, prognosis, symptoms, and relevance to others), target recipients (relational closeness), and disclosure efficacy before pursuing a health-related disclosure. Disclosures take form via six strategies, namely directness, entrapment, incremental disclosures, indirect mediums, third-party disclosures, and preparation and rehearsal (Afifi & Steuber, 2009).
Guided by the DD-MM, the present study assessed racial differences in the associations between information assessment, recipient assessment (relational closeness and perceived support), self-efficacy, and disclosure strategies used between Asian American and White college students. Participants were 26 Asian American and 26 (randomly selected from 106) White American college students who disclosed their mental illness information to a friend. Participants completed electronic surveys that accessed DD-MM variables and disclosure strategies. We performed 12 linear regressions to determine DD-MM predictors per strategy per racial group. Due to small sample size, we conducted a zero-order correlation matrix to narrow predictor variables per strategy. The same predictors were included for both models (Asian and White) per strategy (ex. directness). Regressions revealed that predictors of Asian Americans’ disclosure strategies differ from White peers. Among Asian Americans, anticipated supportive response positively predicted one (directness, t = 2.22, p = .04) and negatively predicted four strategies (preparation and rehearsal, t = -4.65, p = .001; third party, t = -3.64, p = .001; entrapment, t = -3.04, p = .006; indirect mediums, t = -4.88, p = .001). Alternatively, supportive responses did not predict any disclosure strategies among White participants. Among White participants, preparation positively predicted four disclosure strategies (preparation and rehearsal, t = 2.01, p = .05; third party disclosure, t = 2.50, p = .02; entrapment, t = 2.71, p = .01; and indirect mediums, t = 4.33, p = .001). Results indicate minimal similarity in Asian American and White participants’ motivations for differing disclosure strategies when sharing mental health information with friends. Future research should continue to explore the unique motivators of disclosure among various college samples.