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Collado A, Blevins E, MacPherson L. A Preliminary Examination of the Role of Avoidance in Behavioral Activation Treatment Among Latinx Individuals. JOURNAL OF LATINX PSYCHOLOGY 2024; 12:201-209. [PMID: 38738171 PMCID: PMC11086672 DOI: 10.1037/lat0000240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Background The current study examined the role of avoidance in behavioral activation treatment compared to a supportive counseling condition targeting depressive symptoms in a sample comprised of Latinx individuals. Method Depressed Latinx individuals with Spanish-speaking preference (LSSP; N = 46) were randomized to receive 10-weekly sessions of Brief Behavioral Activation Treatment for Depression (BATD) or supportive counseling. Participants completed weekly self-report measures of depressive symptoms and avoidance. Results Avoidance levels decreased over the course of both treatments. However, decreases in depressive symptoms were associated with decreases in avoidance over time only for individuals who were randomized to BATD. Greater change in avoidance levels was related to post-treatment depression score, only for those who received BATD. Finally, greater avoidance prior to commencing treatment predicted lower depressive symptom change over the course of both treatments. Conclusions This study provides preliminary evidence that avoidance may be a specific proposed mechanism of depression change in BATD among LSSP with depression. Pretreatment avoidance appears to be a useful construct to identify the trajectories of depressive symptoms over the course of psychotherapy among LSSP.
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Affiliation(s)
- Anahi Collado
- Renée Crown Wellness Institute, University of Colorado- Boulder
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2
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Elhabashy M, Chiangong J, Villalobos K, Montiel Ishino FA, Adzrago D, Williams F. Prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID-19 pandemic. Sci Rep 2024; 14:6727. [PMID: 38509221 PMCID: PMC10954677 DOI: 10.1038/s41598-024-57064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
Hispanic/Latino populations experienced disproportionate exposure to depression risk factors during the COVID-19 pandemic. While aggregated data confirm the risks of depressive symptoms among Hispanic/Latino individuals, little research uses disaggregated data to investigate these risks based on ethnic subgroups. Using the "Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases" survey, which was distributed nationally between May 13, 2021, and January 9, 2022 (N = 5413), we estimated the prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the pandemic. We performed descriptive analysis on a 116-item survey, which collected disaggregated data from Hispanic/Latino individuals aged ≥ 18 years (n = 1181). About one-third of the participants reported depressive symptoms (31.3%), with those who self-identified as other Hispanic/Latino/Spanish origin (40.2%) reporting the highest depressive symptom prevalence. Among participants who reported depression treatment before the pandemic, the highest reports of treatment were among Puerto Rican (81.8%) participants. More than one-third of participants receiving prior depression treatment (38.7%) reported treatment interference by the pandemic, mostly among Central American individuals (50.0%). This study highlights the need for integrating more disaggregated data into public health approaches which seek to target population subgroups and reduce racial/ethnic mental health disparities.
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Affiliation(s)
- Maryam Elhabashy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Bethesda, MD, USA
| | - Jolyna Chiangong
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Bethesda, MD, USA
| | - Kevin Villalobos
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Bethesda, MD, USA
| | - Francisco A Montiel Ishino
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA
| | - David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Bethesda, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Bethesda, MD, USA.
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Alvarez C, Aryal S, Vrany E, Sanchez R MJ, Quiles R, Escobar-Acosta L, Hill-Briggs F. Remote Delivery of the Cuidándome Telehealth Intervention for Self-Management of Depression and Anxiety Among Latina Immigrant Women: Randomized Controlled Trial. JMIR Form Res 2024; 8:e52969. [PMID: 38190239 PMCID: PMC10804250 DOI: 10.2196/52969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Growing evidence suggests that Latina immigrant survivors of adverse childhood experiences (ACEs) are at increased risk for developing and remaining with either depression or anxiety or both symptoms. This study examined the feasibility and acceptability of a telehealth intervention-Cuidándome (quee-DAN-doh-meh, "taking care of myself"). Cuidándome is a 10-week, patient-centered, trauma-informed intervention delivered by a trained facilitator that promotes self-management of depression and anxiety symptoms through improved problem-solving skills and strategies. OBJECTIVE The aim of this study was to examine the feasibility and acceptability of Cuidándome delivered remotely (via Zoom) with Latina immigrant ACE survivors with either depression or anxiety or both symptoms. We also estimated the effect sizes associated with the intervention on decreasing depression and anxiety symptoms and improving social problem-solving styles. METHODS We evaluated Cuidándome using a randomized controlled trial design. Latina immigrants (N=47) who had experienced at least 1 ACE and had at least mild depression or anxiety symptoms were randomized to Cuidándome or a comparison group delivered by trained facilitators. We assessed for changes in depression and anxiety symptoms as well as social problem-solving styles at baseline, post intervention, and 3- and 6-month follow-up. RESULTS Analyses indicated significant decreases over time within both Cuidándome and comparison groups for depression and anxiety symptoms and maladaptive problem-solving. The intervention effect was largest for anxiety; at 6-month follow-up, Cuidándome participants had significantly lower anxiety scores than the comparison group. In addition, we observed a greater average point reduction in depression symptoms at 6 months among Cuidándome participants (5.7 points) than in the comparison group (3.7 points). CONCLUSIONS A mental health program delivered via Zoom by a trained facilitator was feasible and acceptable to Latina immigrant women and can be beneficial for reducing anxiety and depression symptoms. More research is needed to assess the effectiveness of Cuidándome among a powered sample size of Latina immigrants. TRIAL REGISTRATION ISRCTN Registry ISRCTN16668518; https://www.isrctn.com/ISRCTN16668518.
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Affiliation(s)
- Carmen Alvarez
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Elizabeth Vrany
- Institute of Health System Science, Feinstein Institutes for Medical Research, Department of Medicine, Zucker School of Medicine, New York, NY, United States
| | - Maria Jose Sanchez R
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Rosalphie Quiles
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Felicia Hill-Briggs
- Institute of Health System Science, Feinstein Institutes for Medical Research, Department of Medicine, Zucker School of Medicine, New York, NY, United States
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Zvolensky MJ, Shepherd JM, Garey L, Woody M, Otto MW, Clausen B, Smit T, Mayorga NA, Bakhshaie J, Buitron V. Negative emotional reactivity to minority stress: measure development and testing. Cogn Behav Ther 2024; 53:1-28. [PMID: 37766610 PMCID: PMC10840979 DOI: 10.1080/16506073.2023.2260560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
The purpose of the present investigation was to develop and test a measure of negative emotional reactivity to racial/ethnic minoritized stress. In Study 1, we developed item content for a measure of negative emotional reactivity to racial/ethnic minoritized stress. We then evaluated item performance and produced a refined 15-item scale among a large sample of racial/ethnic minority adults (N = 1,343). Results supported a unidimensional construct and high levels of internal consistency. The factor structure and internal consistency were replicated and extended to a sample of Latinx persons who smoke (N = 338) in Study 2. There was evidence of convergent validity of the Emotional Reactivity to Minoritized Stress (ERMS) total score in terms of theoretically consistent and statistically significant relations with indices of mental health problems, social determinants of health, and substance use processes. There was also evidence that the ERMS demonstrated divergent validity in that it was negatively associated with psychological well-being, health literacy, subjective social status in Study 1, and positive abstinence expectancies in Study 2. Overall, the present study establishes the reliability and validity of measuring individual differences in negative emotional reactivity to racial/ethnic minority stress with the ERMS and that such responsivity is associated with behavioral health problems.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | - Mary Woody
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Bryce Clausen
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, 1 Bowdoin Square, Suite 100, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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5
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Danhauer SC, Brenes GA, Tooze JA, Abubaker T, Thomas A, Howard DS, Puccinelli-Ortega N, Jimenez K, Graves K. Cultural and linguistic adaptation of a telephone-based cognitive-behavioral therapy (CBT) intervention to treat depression and anxiety in Hispanic cancer survivors. J Psychosoc Oncol 2023; 42:558-572. [PMID: 38127055 PMCID: PMC11190035 DOI: 10.1080/07347332.2023.2296045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE/OBJECTIVES The purpose of this study was to transcreate a manualized cognitive-behavioral therapy (CBT) intervention to address depression and anxiety among Hispanic cancer survivors. DESIGN/RESEARCH APPROACH Stakeholders reviewed the CBT workbook for language, content, and cultural relevance. We designed semi-structured interview guides to elicit intervention feedback. SAMPLE/PARTICIPANTS Stakeholder participants were Hispanic cancer survivors (n = 4), bilingual mental health providers (n = 2), and oncology professionals (n = 4). METHODS Transcreation was conducted by initial translation of the workbook followed by incorporation of stakeholder feedback. A bilingual (Spanish and English) interviewer conducted stakeholder interviews. The study team discussed themes/suggestions before refining the workbook. FINDINGS Stakeholders reported enthusiasm for the intervention. We gathered significant feedback regarding wording, images, and resources for the workbook. CONCLUSION Development of culturally appropriate mental health resources for Hispanic cancer survivors is critical. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY By broadening research on psychosocial care to the Hispanic population, we increase the reach of evidence-based psychological care. Future research should fully evaluate the adapted CBT intervention among Hispanic survivors.
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Affiliation(s)
- Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | - Gretchen A. Brenes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine
| | - Janet A. Tooze
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine
| | - Tebianne Abubaker
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | - Alexandra Thomas
- Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest University School of Medicine
| | - Dianna S. Howard
- Department of Internal Medicine, Section on Hematology and Oncology, Wake Forest University School of Medicine
| | | | - Karolina Jimenez
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | - Kristi Graves
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center
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Zvolensky MJ, Shepherd JM, Clausen BK, de Dios M, Cano MÁ, Redmond BY. Differences in smoking behavior and beliefs about abstinence among Latinx individuals with and without depression who smoke cigarettes. J Ethn Subst Abuse 2023:1-19. [PMID: 38108308 PMCID: PMC11182888 DOI: 10.1080/15332640.2023.2293945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
There is a well-established relation between depression and smoking in the general population. However, past work focused on Latinx persons who smoke in relation to depressed affect has yielded inconsistent findings. The present investigation aimed to build on past research and evaluate differences among English-speaking Latinx adults who smoke combustible cigarettes with and without probable depression in terms of cigarette dependence, perceived barriers for quitting, severity of problems when quitting, and smoking abstinence expectancies. The current sample included 338 adult Latinx daily cigarette smokers (Mage = 35.53 years; SD = 8.65; age range 18-61; 37.3% female) that were recruited nationally throughout the US. Results indicated that among Latinx persons who smoke, those with probable depression (compared to those without) demonstrated higher levels of cigarette dependence, more severe problems when trying to quit, greater perceived barriers for quitting, and increased negative abstinence expectancies after adjusting for sociodemographic and concurrent substance use variables. Future work could build from this research to elucidate the role of depression in the maintenance and relapse of smoking among the Latinx population.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
- HEALTH Institute, University of Houston
| | | | | | - Marcel de Dios
- HEALTH Institute, University of Houston
- Department of Psychological, Health, and Learning Sciences, University of Houston
| | - Miguel Ángel Cano
- Peter O’Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center
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7
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Zolnikov TR, Guerra JL, Furio F, Dennis J, Ortega C. A qualitative study understanding immigrant Latinas, violence, and available mental health care. DIALOGUES IN HEALTH 2023; 2:100112. [PMID: 38515490 PMCID: PMC10953983 DOI: 10.1016/j.dialog.2023.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 03/23/2024]
Abstract
Women from Latin American countries experience high levels of psychological and physical abuse and violence. Immigrant Latina women are often subjected to a patriarchal system in both family and government, which has resulted in a variety of complex and far-reaching outcomes. This qualitative study sought to understand the experiences of immigrant Latina women who were exposed to violence, as well as their access to mental health care. This study used 20 interviews with immigrant Latina women from El Salvador, Guatemala, and Mexico who had accessed mental health services in California. The primary themes that emerged from analysis of the data included motivating factors for seeking services (e.g., motherhood, community, hope, and mental health needs), barriers to accessing services (e.g., fatalism, marianismo, stigma, finances, language barriers, threats, abuse, and systemic insensitivity), and treatment and solutions (e.g., empathy, advocacy, and community approaches). These results appeared to be indicative of the importance of addressing sociopolitical, historical, and cultural trauma as an imperative component of effective treatment. In this context, the authors explore liberation psychology, a concept and approach that promotes social justice values and emphasizes the empowerment of immigrant Latina women in clinical practice. It is recommended that the historical sociocultural abuse of immigrant Latina women be thoughtfully considered and discussed in the therapeutic process to create lasting psychological change. Future research, policy efforts, and program development, including psychotherapeutic treatment modalities, should focus specifically on marginalized groups facing barriers to mental health care in order to increase access and effectiveness of treatment.
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Affiliation(s)
- Tara Rava Zolnikov
- California Southern University, School of Behavioral Sciences, Costa Mesa, CA, United States of America
- National University, Department of Community Health, San Diego, CA, United States of America
| | - Jose Luis Guerra
- California Southern University, School of Behavioral Sciences, Costa Mesa, CA, United States of America
| | - Frances Furio
- California State University, Sacramento, Division of Social Work, Sacramento, CA, United States of America
| | - Jessica Dennis
- California Southern University, School of Behavioral Sciences, Costa Mesa, CA, United States of America
| | - Carolyn Ortega
- California Southern University, School of Behavioral Sciences, Costa Mesa, CA, United States of America
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8
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O'Connor EA, Perdue LA, Coppola EL, Henninger ML, Thomas RG, Gaynes BN. Depression and Suicide Risk Screening: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2023; 329:2068-2085. [PMID: 37338873 DOI: 10.1001/jama.2023.7787] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Importance Depression is common and associated with substantial burden. Suicide rates have increased over the past decade, and both suicide attempts and deaths have devastating effects on individuals and families. Objective To review the benefits and harms of screening and treatment for depression and suicide risk and the accuracy of instruments to detect these conditions among primary care patients. Data Sources MEDLINE, PsychINFO, Cochrane library through September 7, 2022; references of existing reviews; ongoing surveillance for relevant literature through November 25, 2022. Study Selection English-language studies of screening or treatment compared with control conditions, or test accuracy of screening instruments (for depression, instruments were selected a priori; for suicide risk, all were included). Existing systematic reviews were used for treatment and test accuracy for depression. Data Extraction and Synthesis One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Findings were synthesized qualitatively, including reporting of meta-analysis results from existing systematic reviews; meta-analyses were conducted on original research when evidence was sufficient. Main Outcomes and Measures Depression outcomes; suicidal ideation, attempts, and deaths; sensitivity and specificity of screening tools. Results For depression, 105 studies were included: 32 original studies (N=385 607) and 73 systematic reviews (including ≈2138 studies [N ≈ 9.8 million]). Depression screening interventions, many of which included additional components beyond screening, were associated with a lower prevalence of depression or clinically important depressive symptomatology after 6 to 12 months (pooled odds ratio, 0.60 [95% CI, 0.50-0.73]; reported in 8 randomized clinical trials [n=10 244]; I2 = 0%). Several instruments demonstrated adequate test accuracy (eg, for the 9-item Patient Health Questionnaire at a cutoff of 10 or greater, the pooled sensitivity was 0.85 [95% CI, 0.79-0.89] and specificity was 0.85 [95% CI, 0.82-0.88]; reported in 47 studies [n = 11 234]). A large body of evidence supported benefits of psychological and pharmacologic treatment of depression. A pooled estimate from trials used for US Food and Drug Administration approval suggested a very small increase in the absolute risk of a suicide attempt with second-generation antidepressants (odds ratio, 1.53 [95% CI, 1.09-2.15]; n = 40 857; 0.7% of antidepressant users had a suicide attempt vs 0.3% of placebo users; median follow-up, 8 weeks). Twenty-seven studies (n = 24 826) addressed suicide risk. One randomized clinical trial (n=443) of a suicide risk screening intervention found no difference in suicidal ideation after 2 weeks between primary care patients who were and were not screened for suicide risk. Three studies of suicide risk test accuracy were included; none included replication of any instrument. The included suicide prevention studies generally did not demonstrate an improvement over usual care, which typically included specialty mental health treatment. Conclusions and Relevance Evidence supported depression screening in primary care settings, including during pregnancy and postpartum. There are numerous important gaps in the evidence for suicide risk screening in primary care settings.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Leslie A Perdue
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Erin L Coppola
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Michelle L Henninger
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Rachel G Thomas
- Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Bradley N Gaynes
- Gillings School of Global Public Health, University of North Carolina School of Medicine, Chapel Hill
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9
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Li G, Cai X, Yang Q, Cui Q, Huang L, Jing X, Wang Y. A review of attentional bias modification trainings for depression. CNS Neurosci Ther 2022; 29:789-803. [PMID: 36377495 PMCID: PMC9928546 DOI: 10.1111/cns.14022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Negative attentional bias is a basic character of depression. The attentional bias modification training (ABMT), being a highly promising and easy-to-use depression intervention technique, has attracted much attention to alleviate depressive symptoms in recent years. However, the effectiveness of ABMT programs was mixed across studies, since it remained unclear the underlying mechanisms of ABMT on alleviating depressive symptoms. We systematically analyzed the main ABMT paradigms to clarify possible mechanisms of effective training and reasons of ineffective training. Valid ABMT programs might alleviate depressive symptoms through regulating self-related rumination or two subcomponents of attentional bias: facilitated attention and impaired attentional disengagement. The reasons for the invalidity of ABMT mainly included the suboptimal design of training procedures, mixed effects of participants' personal characteristics, and the unclear relationship between attentional bias and depression. The ABMT is promising for alleviating depressive symptoms, but training procedures are required to be improved to obtain stable training effects.
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Affiliation(s)
- Guo Li
- Psychological Research and Counseling CenterSouthwest Jiaotong UniversityChengduChina,Institute of Brain and Psychological SciencesSichuan Normal UniversityChengduChina
| | - Xueli Cai
- Psychological Research and Counseling CenterSouthwest Jiaotong UniversityChengduChina
| | - Qian Yang
- Institute of Brain and Psychological SciencesSichuan Normal UniversityChengduChina
| | - Qian Cui
- School of Public Affairs and AdministrationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Lihui Huang
- Institute of Brain and Psychological SciencesSichuan Normal UniversityChengduChina
| | - Xiujuan Jing
- Tianfu College of Southwestern University of Finance and EconomicsChengduChina
| | - Yifeng Wang
- Institute of Brain and Psychological SciencesSichuan Normal UniversityChengduChina
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10
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Hollar SM, Siegel JT. Increasing help-seeking among people with depression by self-distancing using mental time-travel. J Ment Health 2022; 32:575-581. [DOI: 10.1080/09638237.2022.2118684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Sara M. Hollar
- Department of Behavioral and Organizational Studies, Claremont Graduate University, Claremont, USA
| | - Jason T. Siegel
- Department of Behavioral and Organizational Studies, Claremont Graduate University, Claremont, USA
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11
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Quiñonez-Freire C, Vara MD, Herrero R, Mira A, García-Palacios A, Botella C, Baños RM. Cultural adaptation of the Smiling is Fun program for the treatment of depression in the Ecuadorian public health care system: A study protocol for a randomized controlled trial. Internet Interv 2021; 23:100352. [PMID: 33335847 PMCID: PMC7733006 DOI: 10.1016/j.invent.2020.100352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Depression is one of the world's major health problems. Due to its high prevalence, it constitutes the first cause of disability among the Americas, where only a very low percentage of the population receives the adequate evidence-based psychological treatment. Internet-Based Interventions (IBIs) are a great alternative to reduce the treatment gap for mental disorders. Although there are several studies in low-and middle-income countries proving IBIs' feasibility and acceptability, there is still little evidence of the effectiveness in diverse social and cultural contexts such as Latin America. METHODS Two studies will be described: Study 1 is focused on the cultural adaptation of a cognitive-behavioral IBI Smiling is Fun (Botella et al. 2012, 2015) for Ecuadorian population with depression based on the procedure by Salamanca-Sanabria et al. (2018). Study 2 describes the design of a randomized controlled trial to test the preliminary efficacy of the culturally adapted intervention in a Public Health Care setting. A total of 153 patients with mild to moderate degree of depression as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.) and the Patient Health Questionnaire-9 (PHQ-9) will be randomly assigned to either an IBI group using only automated support by the system; an IBI group including also minimal human support; or a waiting list group. The primary outcome (depression) and secondary outcomes (e.g., anxiety, affect, quality of life) will be collected at baseline, 3, 6 and 12 months. Mixed-model analyses with no ad hoc imputations will be conducted. DISCUSSION This paper is pioneering in exploring the role of an Internet-based culturally adapted intervention for depression in a public care context in Ecuador. Results obtained will offer new insights into the viability and effectiveness of digital technologies for the psychological treatment of mental illnesses in developing countries.
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Key Words
- APOI, Attitudes Towards Psychological Online Interventions
- AQoL-6D, Assessment of Quality of Life 6 Dimensions
- BDI-II, Beck Depression Inventory-II
- CEQ, Credibility and Expectancy Questionnaire
- CONSORT, Consolidated Standards of Reporting Trials
- CRQ, Cultural Relevance Questionnaire
- CSQ, Client Satisfaction Questionnaire
- Cultural adaptation
- Depression
- E-SF, Ecuadorian Cultural Version of Smiling is Fun
- EBPTs, Evidence-Based Psychological Treatments
- GAD-7, Generalized Anxiety Disorder-7
- IBIs, Internet-Based Interventions
- ICD-10, International Classification of Diseases-10
- ICERs, Incremental Cost-Effectiveness Ratios
- Internet-based intervention
- Latin America
- M.I.N.I. 5.0, MINI International Neuropsychiatric Interview 5.0
- MCAR, Missing Completely at Random
- OASIS, Overall Anxiety Severity and Impairment Scale
- ODSIS, Overall Depression Severity and Impairment Scale
- PANAS, Positive and Negative Affect Schedule
- PC, Primary Care
- PHC, Public Health Care
- PHQ-9, Patient Health Questionnaire-9
- Public Health Care
- QALYs, Quality-Adjusted Life-Years
- RCI, Reliable Change Index
- RCT, Randomized Control Trial
- Randomized Controlled Trial
- SPIRIT, Recommendations for Interventional Trials
- SUS, System Usability Scale
- TiC-P, Trimbos/iMTA Questionnaire on Costs on Psychiatric Illnesses
- WAI-TECH-SF, Working Alliance Inventory for Online Intervention-Short Form
- WL, Waiting List
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Affiliation(s)
- Carlos Quiñonez-Freire
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- Mental Health Unit, Hospital Dr, Gustavo Dominguez Z, Santo Domingo, Ecuador
| | - M. Dolores Vara
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Rocío Herrero
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Adriana Mira
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Azucena García-Palacios
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Cristina Botella
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
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12
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Gonzalez-Mercado VJ, Marrero S, Marrero-Falcon MA, Saligan LN. Factors Affecting the Severity of Fatigue during Radiotherapy for Prostate Cancer; an Exploratory Study. UROLOGIC NURSING 2020; 40:129-138. [PMID: 34220179 PMCID: PMC8248518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Limited studies have examined potential risk factors associated with the fatigue experience of a sample of Puerto Rican men treated with radiotherapy for non-metastatic prostate cancer. Identifying these factors may provide initial information about targets for individualized interventions, leading to more effective management of fatigue in this population. PURPOSE To examine the relationship of age, body max index, depressive symptoms, physical activity, and sleep disturbance with fatigue during radiotherapy for prostate cancer. METHODS Twenty six participants completed five inventories: demographic intake, health form, the Functional Assessment of Cancer-Therapy-fatigue, Patient-Reported Outcome Measures Information System-Sleep disturbance, and the International Physical Activity Questionnaire-Short Form before, middle/days 19-21 and completion/days 38-42 of radiotherapy. The principal investigator rated the Hamilton depression scale. Descriptive statistics were performed. Interactions and influence of variables on fatigue were assessed using bivariate correlation and multiple linear regression, respectively. RESULTS At each study time point, sleep disturbance and depressive symptoms were strongly correlated with each other and fatigue. The linear combination of sleep disturbance and depressive symptoms was significantly related to fatigue. CONCLUSION Given the high association of sleep disturbance and depressive symptoms with fatigue, clinicians should assess and develop interventions to manage these symptoms altogether.
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Affiliation(s)
| | - Sara Marrero
- University of South Florida College of Arts and Sciences, Tampa, FL, United States
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13
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Lee J, Hong J, Zhou Y, Robles G. The Relationships between Loneliness, Social Support, and Resilience among Latinx Immigrants in the United States. CLINICAL SOCIAL WORK JOURNAL 2020; 48:99-109. [PMID: 33583968 PMCID: PMC7880232 DOI: 10.1007/s10615-019-00728-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Globally, international migrants are at elevated risk for experiencing loneliness due to separation from social networks in their countries of origin. In the United States, the political rhetoric has been particularly exclusionary against Latinx immigrants, exposing them to discrimination and fear of deportation. Such environments may result in heightened levels of social isolation, which may contribute to greater risk of poor mental and physical health outcomes. Latinx immigrants, however, may access social support in their destination communities that buffers against these negative outcomes. This study sought to examine how social support and loneliness shape Latinx immigrants' abilities to address the challenges related to migration. Multivariate linear regression analyses were conducted with survey data collected from Latinx immigrants in New York City (n=306). Results revealed that Latinx immigrants with greater social support and less feelings of loneliness were more resilient. Specifically, findings suggest that social support may partially protect against the negative impact of isolation on Latinx immigrants' capacity to thrive. Clinical social workers who work with immigrant groups may consider how migration during the life course affects immigrants' social supports and experiences of loneliness. Social work interventions that integrate strategies to increase social support may provide opportunities to address social isolation and other obstacles associated with migration. Such approaches acknowledge loneliness not only as a psychological symptom, but also as a consequence of unfavorable social environments towards immigrant populations. Future research may develop and assess culturally relevant strategies to promote social support and reduce loneliness among marginalized immigrants.
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Affiliation(s)
- Jane Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Jeeyeon Hong
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Yuanjin Zhou
- School of Social Work, University of Washington, Seattle, WA, USA
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14
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Hollar SM, Siegel JT. Self-distancing as a path to help-seeking for people with depression. Soc Sci Med 2020; 245:112700. [DOI: 10.1016/j.socscimed.2019.112700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 11/14/2019] [Accepted: 11/23/2019] [Indexed: 02/08/2023]
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15
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Dahne J, Collado A, Lejuez CW, Risco CM, Diaz VA, Coles L, Kustanowitz J, Zvolensky MJ, Carpenter MJ. Pilot randomized controlled trial of a Spanish-language Behavioral Activation mobile app (¡Aptívate!) for the treatment of depressive symptoms among united states Latinx adults with limited English proficiency. J Affect Disord 2019; 250:210-217. [PMID: 30870770 PMCID: PMC6461510 DOI: 10.1016/j.jad.2019.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/01/2019] [Accepted: 03/03/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment. METHODS Participants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app ("iCouch CBT"; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. RESULTS All ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!. LIMITATIONS Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. CONCLUSIONS With further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.
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Affiliation(s)
- Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States; Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States.
| | - Anahi Collado
- Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD 20852, United States; Department of Psychology and Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, United States
| | - C W Lejuez
- Department of Psychology and Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, United States
| | - Cristina M Risco
- Department of Psychology and Office of the Senior Vice President and Provost, University of Maryland, College Park, 2131 Biology-Psychology Building, College Park, MD 20742, United States
| | - Vanessa A Diaz
- Department of Family Medicine, Medical University of South Carolina, 5 Charleston Center, Suite 263, Charleston SC 29425, United States
| | - Lisa Coles
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States
| | - Jacob Kustanowitz
- MountainPass Technology, 2 Wisconsin Circle, Suite 700, Chevy Chase, MD 20815, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Fred J. Heyne Building, Suite 104, Houston, Texas 77204, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, Texas 77030, United States
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States; Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States
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Salamanca-Sanabria A, Richards D, Timulak L. Adapting an internet-delivered intervention for depression for a Colombian college student population: An illustration of an integrative empirical approach. Internet Interv 2019; 15:76-86. [PMID: 30740313 PMCID: PMC6356089 DOI: 10.1016/j.invent.2018.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/15/2018] [Accepted: 11/05/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Culturally adapted psychotherapy (CAP) studies are limited and until now there are few published examples that illustrate the process of cultural adaptation with internet-delivered treatments. AIM This paper aims to illustrate an integrative approach to the cultural adaptation of an evidence-based internet-delivered cognitive-behavioural therapy intervention for depression (Space from Depression programme). METHOD Mixed method approach utilising quantitative and qualitative methods to assist in the cultural adaptation of the Space from Depression programme was used. The adaptation involved a framework for cultural sensitivity (CSF), alongside an ecological validity framework (EVF) and principles from cross-cultural assessment research. The method included the development of a theory-informed measure, the Cultural Relevance Questionnaire (CRQ), designed specifically for this research. RESULTS The adaptation included an establishment of CSF, which included the incorporation of Colombian cultural expressions. College students' (n = 5) and experts' (n = 7) evaluated the EVF based on cross-cultural assessment principles of a preliminary adapted version through the CRQ, showing reliability in the sample (Cronbach's Alpha 0.744). Qualitative analysis supported the culturally sensitive changes or incorporations made to the programme, such as: personal stories and textual translations from English and these were considered ecologically valid and representative. CONCLUSIONS The research provided support for the idea that CAP can be conducted systematically for internet-delivered interventions.
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Affiliation(s)
- Alicia Salamanca-Sanabria
- E-mental Health Research Group, School of Psychology, Trinity College Dublin, Dublin, Ireland,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland,Corresponding author at: E-mental Health Research Group, School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Derek Richards
- E-mental Health Research Group, School of Psychology, Trinity College Dublin, Dublin, Ireland,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Ladislav Timulak
- E-mental Health Research Group, School of Psychology, Trinity College Dublin, Dublin, Ireland
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Zeber JE, Coleman KJ, Fischer H, Yoon T, Ahmedani BK, Beck A, Hubley S, Imel Z, Rossom RC, Shortreed SM, Stewart C, Waitzfelder BE, Simon GE. The impact of race and ethnicity on rates of return to psychotherapy for depression. Depress Anxiety 2017; 34:1157-1163. [PMID: 29095538 PMCID: PMC5718939 DOI: 10.1002/da.22696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/21/2017] [Accepted: 09/28/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There are many limitations with the evidence base for the role of race and ethnicity in continuation of psychotherapy for depression. METHODS The study sample consisted of 242,765 patients ≥ 18 years old from six healthcare systems in the Mental Health Research Network (MHRN) who had a new episode of psychotherapy treatment for depression between 1/1/2010 and 12/31/2013. Data were from electronic medical records and organized in a Virtual Data Warehouse (VDW). The odds of racial and ethnic minority patients returning for a second psychotherapy visit within 45 days of the initial session were examined using multilevel regression. RESULTS The sample was primarily middle aged (68%, 30-64 years old), female (68.5%), and non-Hispanic white (50.7%), had commercial insurance (81.4%), and a low comorbidity burden (68.8% had no major comorbidities). Return rates within 45 days of the first psychotherapy visit were 47.6%. Compared to their non-Hispanic white counterparts, racial and ethnic minority patients were somewhat less likely to return to psychotherapy for a second visit (adjusted odds ratios [aORs] ranged from 0.80 to 0.90). Healthcare system was a much stronger predictor of return rates (aORs ranged from 0.89 to 5.53), while providers accounted for 21.1% of the variance in return rates. CONCLUSIONS Provider and healthcare system variation were stronger predictors of patient return to psychotherapy than race and ethnicity. More research is needed to understand why providers and healthcare systems determine psychotherapy return rates for patients of all racial and ethnic groups.
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Affiliation(s)
- John E. Zeber
- Baylor Scott & White Health, Center for Applied Health Research; Central Texas Veterans Health Care System; Temple, TX
| | - Karen J. Coleman
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Heidi Fischer
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Tae Yoon
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Brian K. Ahmedani
- Henry Ford Health System, Behavioral Health Services and Center for Health Policy and Health Services Research, Detroit, MI
| | - Arne Beck
- Kaiser Permanente Colorado, Institute for Health Research, Denver, CO
| | | | - Zac Imel
- University of Utah, Salt Lake City, UT
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18
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The association between cognitive decline and incident depressive symptoms in a sample of older Puerto Rican adults with diabetes. Int Psychogeriatr 2017; 29:1317-1325. [PMID: 28511740 PMCID: PMC5527968 DOI: 10.1017/s1041610217000746] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Older Puerto Rican adults have particularly high risk of diabetes compared to the general US population. Diabetes is associated with both higher depressive symptoms and cognitive decline, but less is known about the longitudinal relationship between cognitive decline and incident depressive symptoms in those with diabetes. This study investigated the association between cognitive decline and incident depressive symptoms in older Puerto Rican adults with diabetes over a four-year period. METHODS Households across Puerto Rico were visited to identify a population-based sample of adults aged 60 years and over for the Puerto Rican Elderly: Health Conditions study (PREHCO); 680 participants with diabetes at baseline and no baseline cognitive impairment were included in analyses. Cognitive decline and depressive symptoms were measured using the Mini-Mental Cabán (MMC) and Geriatric Depression Scale (GDS), respectively. We examined predictors of incident depressive symptoms (GDS ≥ 5 at follow-up but not baseline) and cognitive decline using regression modeling. RESULTS In a covariate-adjusted logistic regression model, cognitive decline, female gender, and greater diabetes-related complications were each significantly associated with increased odds of incident depressive symptoms (p < 0.05). In a multiple regression model adjusted for covariates, incident depressive symptoms and older age were associated with greater cognitive decline, and higher education was related to less cognitive decline (p < 0.05). CONCLUSIONS Incident depressive symptoms were more common for older Puerto Ricans with diabetes who also experienced cognitive decline. Efforts are needed to optimize diabetes management and monitor for depression and cognitive decline in this population.
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Pineros-Leano M, Liechty JM, Piedra LM. Latino immigrants, depressive symptoms, and cognitive behavioral therapy: A systematic review. J Affect Disord 2017; 208:567-576. [PMID: 27810273 DOI: 10.1016/j.jad.2016.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/14/2016] [Accepted: 10/22/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND In order to address the needs of the growing Latino immigrant population, this study aimed to systematically review peer-reviewed articles of intervention studies that used cognitive behavioral therapy to treat depressive symptoms among Latino immigrants in the U.S. METHODS We searched PsycINFO, PubMed, and Medline databases from January 1995 through July 2016 as part of a registered review protocol (PROSPERO) following PRISMA guidelines. Inclusion criteria were intervention studies that used cognitive behavioral techniques to treat depressive symptoms among a predominantly U.S. Latino immigrant sample -- or subsample with disaggregated results, and the use of standardized measures of depression. We used the National Heart, Lung, and Blood Institute quality assessment tools for systematic reviews to assess risk of bias. RESULTS We identified 11 studies that met inclusion criteria. Nine of the included studies reported a reduction of depressive symptoms. Each study used a least one cultural adaptation to deliver the intervention. Using an existing content model, cultural adaptations were categorized as (a) cognitive-informational adaptations, (b) affective-motivational adaptations, and (c) environmental adaptations. LIMITATIONS Heterogeneity of articles in terms of sample size, cultural adaptations, methodological rigor, and setting limited comparability of effectiveness across studies. CONCLUSIONS Culturally adapted CBT to address depressive symptoms among Latino immigrants appears promising but further research is needed. The most commonly used cultural adaptations included language, inclusion of migration experience, and adjusting for literacy level. Study design elements and adaptations were often responsive to geographic characteristics and available resources.
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Affiliation(s)
| | - Janet M Liechty
- School of Social Work, University of Illinois at Urbana-Champaign, USA; College of Medicine, University of Illinois at Urbana-Champaign, USA
| | - Lissette M Piedra
- School of Social Work, University of Illinois at Urbana-Champaign, USA
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