This current study analyzes the content of popular pornographic videos, with the objectives of updating depictions of aggression, degradation, and sexual practices and comparing the study’s results to previous content analysis studies. Findings indicate high levels of aggression in pornography in both verbal and physical forms. Of the 304 scenes analyzed, 88.2% contained physical aggression, principally spanking, gagging, and slapping, while 48.7% of scenes contained verbal aggression, primarily name-calling. Perpetrators of aggression were usually male, whereas targets of aggression were overwhelmingly female. Targets most often showed pleasure or responded neutrally to the aggression.

Using data collected from 1,880 heterosexual men and women residing in the United States, this study investigated the associations among gender, pornography consumption, and 20 sexual behaviors observed in popular pornography. Acts were grouped according to whether participants reported engaging or being interested in trying specific sexual behaviors as the (a) aggressor (e.g., hairpulling, spanking, or choking), (b) target (e.g., being spanked or choked), or (c) uncommon and/or degrading sexual activity (e.g., male ejaculation in female partner’s mouth, anal sex, double penetration, and ass-to-mouth). Using sexual script theory, we hypothesized greater use of pornography would be associated with greater likelihood of both having engaged in and interest in engaging in these sexual behaviors. We further hypothesized gender differences consistent with pornographic sexual scripts that frequently portray men as aggressors and women as targets of aggression. Hierarchical multiple regressions revealed significant main effects for gender and pornography use on the three categories of sexual behavior but no significant interactions. Higher pornography use was associated with greater likelihood of both engaging and being interested in trying all categories of sexual behavior. Men were more likely than women to have engaged in aggressive and degrading/uncommon behaviors, and women were more likely than men to have engaged in target behaviors. However, men were more interested than women in trying all three categories of sexual behavior. Results provide partial support for sexual script theory; while higher pornography use increased interest and prior engagement in pornography-like sexual behavior, the increases in types of sexual behavior (aggressor, target, or uncommon/degrading) were not moderated by gender.

Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos.

Purpose: This study assessed mental health needs and service utilization patterns in a convenience sample of Hispanic immigrants. Design and Method: A total of 84 adult Hispanic participants completed a structured diagnostic interview and a semistructured service utilization interview with trained bilingual research assistants. Results: In the sample, 36% met diagnostic criteria for at least one mental disorder. Although 42% of the sample saw a physician in the prior year, mental health services were being rendered primarily by religious leaders. The most common barriers to service utilization were cost (59%), lack of health insurance (35%), and language (31%). Although more women than men met criteria for a disorder, service utilization rates were comparable. Participants with a mental disorder were significantly more likely to have sought medical, but not psychiatric, services in the prior year and faced significantly more cost barriers than participants without a mental disorder. Conclusions: Findings suggest that Hispanic immigrants, particularly those with a mental illness, need to access services but face numerous systemic barriers. The authors recommend specific ways to make services more affordable and linguistically accessible.

The discrepancy between the growing number of Spanish speakers in the U.S. and the availability of bilingual providers creates a barrier to accessing quality mental health care. Use of interpreters provides one strategy for overcoming this linguistic barrier; however, concerns about whether sessions with interpreters, versus bilingual providers, impede therapeutic alliance remain. The current study explored associations between the use of interpreters and therapeutic alliance in a sample of 458 Spanish-speaking patients seen for integrated behavioral health visits at primary care clinics. Patients completed a brief (4 item) therapeutic alliance scale at their behavioral health appointment. In addition, to supplement the quantitative study data, a pilot study of 30 qualitative interviews was conducted with a new sample of 10 Spanish-speaking patients, 10 behavioral health consultants (BHCs), and 10 trained interpreters. Quantitative results showed that interpreter use did not relate to therapeutic alliance, even when controlling for relevant demographic variables. However, qualitative interviews suggested major themes regarding the relative benefits and challenges of using interpreters for patients, interpreters, and BHCs. In interviews, patients expressed a strong preference for bilingual providers. Benefits included greater privacy, sense of trust, and accuracy of communication. However, in their absence, interpreters were seen as increasing access to services and facilitating communication with providers, thereby addressing the behavioral health needs of patients with limited English proficiency. BHCs and interpreters emphasized the importance of interpreter training and a good collaborative relationship with interpreters to minimize negative effects on the quality of care.