American parents' willingness to prescribe psychoactive drugs to children: A test of cultural mediators

Purpose: In the USA, white children receive psychoactive drugs more often than black or Hispanic children. This study investigates whether cultural attitudes statistically mediate differences between American parents' self-identified racial-ethnic group membership and their willingness to medicate children for behavioral problems. Methods: Using data from telephone interviews with 1,145 parents in two Florida counties, structural models tested associations between each group compared with the other, in willingness to medicate children exhibiting different problematic behaviors and hypothesized cultural (familism, fatalism, attitude toward corporal punishment, religiosity, concern about treatment stigma, birth abroad, language of interview) and other mediators (views about medications and causes of children's problems). Respondent gender, age, socioeconomic status, parent-type household, taking psychoactive medication, and having a child with behavioral problems were used as covariates. Results: Race-ethnicity was strongly associated with specific cultural attitudes and views about medications and problems, but only Hispanics distinguished themselves significantly from whites in willingness to medicate children. Across groups, parents who viewed medication favorably and endorsed biomedical causes for problems were more willing to medicate. In Hispanic-white and Hispanic-black comparisons, being interviewed in Spanish was the sole but modest cultural mediator of willingness, and in black-white comparisons, only concern about treatment stigma weakly mediated differences in willingness. Conclusions: These findings provide faint support for a parent-centered cultural explanation of reported prescription differences among youths of different racial-ethnic groups in the USA. However, structural and professional components of a broader cultural hypothesis for such differences, within the USA and between different countries, still require evaluation.