Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation




Educational and Counseling Psych

First Advisor

Dr. Joseph H. Hammer


U.S. Veterans are less likely to seek help than their civilian counterparts despite having higher levels of self-reported distress, in part due to comparatively poorer attitudes towards seeking mental health treatment. While some aspects of cultural socialization (e.g., gender role expectations, certain types of stigma) have been established to influence Veterans’ attitudes towards mental health treatment, other aspects of health care access (e.g., trust in health care institutions or individual providers) may benefit from increased focus. Additionally, one aspect of cultural socialization that is understudied in white Veterans is that of racial-cultural socialization (i.e., whiteness). Much of the research into veterans’ help seeking does not account for white veterans’ unique racial-cultural socialization, making whiteness invisible and furthering the assumption that racial socialization does not apply to white people, despite the U.S. military’s general milieu as a white space. The present study, grounded in the Integrated Behavioral Model (IBM), addresses these research and treatment gaps by using an alternative SEM model testing framework in 377 white Veterans to examine the direct and indirect links between ten sociocultural variables and attitudes towards seeking help from Veterans Health Administration (VHA) mental health services in white veterans. Sociocultural variables include self-stigma of seeking help, individual provider trust, perceived stigma from other veterans, perceived stigma of loved ones, beliefs about VA health care system competence, emotional control, perfectionism, either-or thinking, and military identity commitment. Key findings include: individuals high in either-or thinking, perceived stigma of loved ones, and with low perceived trust in VA system competence had poorer attitudes towards VHA mental health care both directly and indirectly via self-stigma of seeking help and trust in a hypothetical VA mental health provider. In particular, the relationships between multiple aspects of stigma and the relationship between trust in the VA institution and individual VA providers are discussed. Results indicate addressing these stigma and trust constructs, as well as addressing aspects of white racial-cultural socialization (i.e., either-or thinking and perfectionism) in research and clinical work with white Veterans, may improve attitudes towards VA mental health care in this population.

Digital Object Identifier (DOI)