05. Exploring Associations between Latino Cultural Values, ADHD Stigma, and Help-Seeking Attitudes in a Community Sample in Mexico: A Mediation Analysis

Associations between mental health stigma and help-seeking are well-researched, but there is limited understanding of associations between ADHD stigma, cultural values, and help-seeking attitudes. We examined if the hypothesized association of adherence to Latino cultural values (including familismo and respeto) and help-seeking attitudes is mediated by ADHD stigma in a secondary analysis of cross-sectional survey data from 313 school staff and parents of children from 8 public elementary schools participating in a trial of the Collaborative Life Skills school-based ADHD program in Mexico (CLS-FUERTE). Families and teachers were shown a behavioral impairment video of a child portraying ADHD features and asked to complete the ADHD Stigma Questionnaire, Mexican American Cultural Values scale, Problem Recognition and Service Selection Questionnaire, Child Symptom Inventory, and ADHD-FX scale. The outcome, help-seeking attitudes, is split into two domains: ADHD problem recognition and types of help participants considered appropriate. We conducted a causal mediation analysis to assess the direct and indirect effects of Latino cultural values on help-seeking attitudes, with ADHD stigma as a mediator on the causal pathway. Results analyze three causal estimands: the natural indirect effect (NIE), natural direct effect (NDE), and controlled direct effect (CDE). We aim to assess multiple levels of confounding using a counterfactual framework. Results yield understanding of how ADHD stigma may mediate the association of adherence to Latino cultural values and help-seeking attitudes (NIE), how much of this association may filter through non-ADHD stigma pathways (NDE), and the expected association of adherence to Latino cultural values and help-seeking attitudes if ADHD stigma were eliminated (CDE). We aim improve understanding of and address ADHD stigma in culturally adapted services, reducing disparities for underserved populations like Spanish-speaking youth.

ADHD

Latino Cultural Values

Mental Health Stigma

Help-Seeking Attitudes 

Mid-Level

Knowledge

Women in Statistics and Data Science 2025