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Jhawar N, Antshel K. Asian Indian American Parental Help-Seeking Intentions for ADHD. Res Child Adolesc Psychopathol 2023; 51:1551-1563. [PMID: 37535225 DOI: 10.1007/s10802-023-01108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/04/2023]
Abstract
Minoritized ethnic groups experience both delay to treatment and low rate of treatment contact for attention deficit/hyperactivity disorder (ADHD). To date, Asian Indian Americans have been excluded completely from ADHD help-seeking research. To fill this void, the Theory of Planned Behavior (TPB) was used to investigate the influence of race/ethnicity on parents' help-seeking intentions for their child's elevated ADHD symptoms. Parents (n = 191, 53% Asian Indian American, 47% European American; 63.9% fathers) of treatment naïve children at high risk for ADHD completed an online survey to assess their recognition of ADHD, knowledge of ADHD etiology, attitudes towards ADHD treatment, subjective norms regarding ADHD treatment, perceived control over their ADHD help-seeking behavior, and intention to seek help for their child's elevated ADHD symptoms. Hierarchical linear regressions demonstrated that perceived behavioral control independently predicted intention to seek help in the total sample and may be more impactful for European American parents than Asian Indian American parents. In contrast, subjective norms were more influential for help-seeking intentions among Asian Indian American parents. However, attitudes towards ADHD were not significantly associated with the intention to seek help among both ethnicities. Asian Indian American parents endorsed lower levels of biopsychosocial etiology beliefs. Together, the results inform possible methods of increasing treatment engagement for both groups of parents who have children at high risk for ADHD.
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Affiliation(s)
- Nandini Jhawar
- Department of Psychology, Syracuse University, Syracuse, NY, United States of America.
| | - Kevin Antshel
- Department of Psychology, Syracuse University, Syracuse, NY, United States of America
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Edwards NM, Isik-Ercan Z, Lu HT, Fall M, Sebti L. "Do the Best You Can with Resources You Have to Offer": Community stakeholder views on supporting immigrant families. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:837-859. [PMID: 36413594 DOI: 10.1002/jcop.22970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
First and second-generation immigrant families of young children in the United States face potential challenges that may be mitigated with stakeholder support in their communities. We examined self-reported views and behaviors among professionals (n = 76) working with families in a mid-Atlantic urban community, and whether these views correlated with demographic factors. Over half of respondents were not able/willing to report the number of immigrant families served and over half believed immigrant parents are less likely to advocate for themselves or their child. Participants were fairly split in seeking advice from others and comfort in talking with immigrant families about their culture/needs. It is essential to assess stakeholders' views on perceived roles, roadblocks, and desired supports. This analysis informs efforts to work more collaboratively with community partners to improve outreach to immigrant families during those formative years in a child's development. Implications for research, practice, and policy are discussed.
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Affiliation(s)
- Nicole Megan Edwards
- Department of Interdisciplinary and Inclusive Education, College of Education, Rowan University, Glassboro, New Jersey, USA
| | - Zeynep Isik-Ercan
- Department of Interdisciplinary and Inclusive Education, College of Education, Rowan University, Glassboro, New Jersey, USA
| | - Huan-Tang Lu
- Department of Educational Services and Leadership, College of Education, Rowan University, Glassboro, New Jersey, USA
| | - Madjiguene Fall
- School of Curriculum & Teaching, College of Education, Kean University, Union, New Jersey, USA
| | - Latifa Sebti
- Doctoral Candidate, PhD in Education: Special Education Concentration, College of Education, Rowan University, Glassboro, New Jersey, USA
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Jin L, Compton SE, Sameen DE, Cornish MV, Contractor AA. Mental Health Symptom Profiles and Treatment Parameters Among Asian Indians: Latent Profile Analyses. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01040-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Ikram M, Shaikh NF, Siddiqui ZA, Dwibedi N, Misra R, Vishwanatha JK, Sambamoorthi U. Factors associated with COVID-19-related mental health among Asian Indians in the United States. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 11:100472. [PMID: 36624854 PMCID: PMC9812469 DOI: 10.1016/j.jadr.2023.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/14/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Background In the United States, the COVID-19 pandemic has caused increased mental health symptoms and mental illness. Specific subgroups such as Asian Indians in the US have also been subject to additional stressors due to unprecedented loss of lives in their home country and increased Asian hate due to the misperception that Asians are to be blamed for the spread of the SARS-CoV-2. Objective We examined the various factors including discrimination associated with COVID-19-related mental health symptoms among Asian Indians. Methods We administered an online survey between May 2021 and July 2021 using convenient and snowball sampling methods to recruit Asian Indian adults (age > 18 years, N = 289). The survey included questions on mental health and the experience with unfair treatment in day-to-day life. Descriptive analysis and logistic regressions were performed. Results Overall, 46.0% reported feeling down, depressed, or lonely and feeling nervous, tense, or worried due to the COVID-19 pandemic; 90.0% had received at least one dose of vaccination and 74.7% reported some form of discrimination. In the fully-adjusted logistic regression, age (AOR = 0.95; 95%CI- 0.92, 0.97;p < 0.01) and general health (AOR=0.84; 95%CI- 0.73, 0.97; p < 0.015) were negatively associated with mental health symptoms. Participants who experienced discrimination were more likely (AOR=1.26; 95%CI- 1.08, 1.46; p < 0.01) to report mental health symptoms. Conclusion In this highly vaccinated group of Asian Indians discriminatory behaviors were associated with mental health symptoms suggesting the need for novel institutional level policy responses to reduce anti-Asian racism.
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Affiliation(s)
- Mohammad Ikram
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510 Morgantown, WV 26506-9510, United States
| | - Nazneen Fatima Shaikh
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510 Morgantown, WV 26506-9510, United States
| | - Zasim Azhar Siddiqui
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center [North], P.O. Box 9510 Morgantown, WV 26506-9510, United States
| | - Nilanjana Dwibedi
- The Janssen Pharmaceutical Companies of Johnson & Johnson, United States
| | - Ranjita Misra
- Social and Behavioral Sciences, School of Public Health, West Virginia University, PO Box 9190,3812 B HSC South, Department of Social & Behavioral Sciences, Morgantown, WV 26506, United States
| | - Jamboor K Vishwanatha
- Texas Center for Health Disparities, National Research Mentoring Network, AIM-AHEAD Coordinating Center, Texas CEAL Consortium, Institute for Health Disparities, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Usha Sambamoorthi
- Pharmacotherapy Department, College of Pharmacy, University of North Texas Health Sciences Center,"Vashisht" Professor of Asian Health Disparities HEARD Scholar, United States
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Siddiqui ZA, Sambamoorthi U. Psychological Distress Among Asian Indians and Non-Hispanic Whites in the United States. Health Equity 2022; 6:516-526. [PMID: 36186615 PMCID: PMC9518809 DOI: 10.1089/heq.2021.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The prevalence of psychological distress (PD) among Asian Indians is unknown. This study estimated and compared moderate-serious PD in Asian Indians and non-Hispanic Whites (NHWs) in the United States. Methods We used a cross-sectional design using the National Health Interview Survey (2012-2017). Adult (age >18 years) NHWs and Asian Indians (N=2,218) were included. PD was measured using the six-item Kessler (K6) scale. We used multivariable logistic regression to determine the association of Asian Indian ethnicity with PD. Results In the analysis, 19.9% of NHWs and 11.0% of Asian Indians reported moderate-serious PD. Asian Indians were less likely to report PD in both unadjusted (unadjusted odds ratio=0.50; 95% confidence interval [CI]=0.42-0.58) and fully adjusted (adjusted odds ratio=0.7; 95% CI 0.59-0.82) models. Conclusions Asian Indians had a lower prevalence of PD than NHWs, likely due to multiple protective factors such as high socioeconomic status and lower multimorbidity.
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Affiliation(s)
- Zasim Azhar Siddiqui
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia, USA
- Department of Pharmacotherapy, College of Pharmacy, Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Mudunna C, Antoniades J, Tran T, Fisher J. Factors influencing the attitudes of young Sri Lankan-Australians towards seeking mental healthcare: a national online survey. BMC Public Health 2022; 22:546. [PMID: 35305611 PMCID: PMC8933917 DOI: 10.1186/s12889-022-12842-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background Sri Lankans, as part of the South Asian diaspora, comprise one of the largest migrant groups in Australia. Although few data are available, South Asian migrants appear to experience higher rates of mental health problems, but seek help at lower rates than other migrant groups. Understanding factors that underpin mental health care seeking is necessary to inform mental health promotion strategies, including access to care. The aim was to investigate factors influencing attitudes to seeking care for mental health problems among young Sri Lankan-Australians born in Sri Lanka or in Australia. Methods An anonymous cross- sectional online survey which included the Multiethnic Identity Measure, Perceived Stigma Questionnaire, General Help-Seeking Questionnaire, Attitudes Towards Seeking Professional Psychological Help questionnaire and study specific questions to ascertain sociodemographic characteristics. The survey was advertised on social media and specifically included young adults aged between 18–30, who self-identified as being of Sri Lankan heritage and were living in Australia. Participation was not possible for those that did not have access to the internet. Data were analyzed using bivariable and multivariable statistics. Results Of the 396 people who attempted the survey, 323 provided fully completed data, 2 provided > 50% completed data which were included in the analyses. 71 were excluded because < 50% of the survey was completed. From all participants, 39.70% were born in Australia (SLaus), 54.46% born in Sri Lanka (SLsl) and 5.8% born in other countries. SLsl had more stigmatizing attitudes towards mental illness (p = 0.027) and seeking professional psychological help (p = 0.03). Women, those who had spent more years living in Australia and whose fathers were more highly educated had less stigmatized attitudes toward mental illness and help-seeking. Conclusion Country of birth, family characteristics and gender influence stigma towards mental illness and help-seeking. Public health strategies to promote understanding of mental health problems and seeking mental healthcare are more likely to be effective if they address these factors directly.
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Sunderaraman P, Irani F, Krishnan K, Hundal JS. A narrative review of the biopsychosocial and health characteristics of Asian Indians in the United States: Clinical and research implications for neuropsychological functioning. Clin Neuropsychol 2021:1-19. [PMID: 34818985 DOI: 10.1080/13854046.2021.1987524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The prevailing scientific literature aggregates Asians living in America into one omnibus category and thus can problematically result in a subpar and at times inaccurate understanding of health, social and cultural factors necessary for competent and informed medical care. Method: A literature search was conducted by cultural experts familiar with Asian Indian culture with a focus on immigrants from this community living in the US. Database using search engines was sought in the following domains: immigration patterns, prevalence for key medical and neurological conditions commonly associated with cognitive dysfunction, psychiatric/psychological needs in the community, some preliminary neuropsychological testing considerations while working with this community, and treatment considerations that could affect adherence and efficacy of outcomes. Articles were selected from 2000 to the most recent date, with emphasis on compiling information from review papers and meta-analysis from the past decade. Conclusions: Asian Indians living in the US are distinct from the larger Asian American community. Immigration trends underscore that Asian Indians have a bimodal distribution of wealth. Regarding medical conditions, a key and highly concerning finding is the higher prevalence of cardiovascular risk factors, especially in young males. The lack of non-existent cognitive data in this community is glaring and should serve as an impetus for conducting high-priority research in this community. Preliminary neuropsychological testing considerations are discussed from a practical perspective with emphasis on multilingualism and region of origin. Finally, treatment considerations include understanding attitudes and beliefs regarding traditional medicine.
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Affiliation(s)
- Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H.Sergeivsky Center, and the Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.,The Framingham Heart Study - Brain Aging Program, 73 Mount Wayte Avenue, Framingham, MA, USA
| | | | - Kamini Krishnan
- Lou Ruvo Center for Brain Health, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jasdeep S Hundal
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Ahmed S, Birtel MD, Pyle M, Morrison AP. Stigma towards psychosis: Cross‐cultural differences in prejudice, stereotypes, and discrimination in White British and South Asians. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/casp.2437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Sehar Ahmed
- Division of Psychology and Mental HealthUniversity of Manchester Manchester M13 9PL UK
| | - Michèle D. Birtel
- Division of Psychology and Mental HealthUniversity of Manchester Manchester M13 9PL UK
- School of Human SciencesUniversity of Greenwich London SE10 9LS UK
| | - Melissa Pyle
- Psychosis Research UnitGreater Manchester Mental Health NHS Foundation Trust Manchester M25 9WS UK
| | - Anthony P. Morrison
- Division of Psychology and Mental HealthUniversity of Manchester Manchester M13 9PL UK
- Psychosis Research UnitGreater Manchester Mental Health NHS Foundation Trust Manchester M25 9WS UK
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Firoozabadi A, Golshani S, Razeghian L, Rahimi S, Sepehry AA, Farnia V, Tatari F, Hookari S, Alikhani M. Dissociative Experiences In Iranian Depressed Patients. J Trauma Dissociation 2019; 20:445-456. [PMID: 30945624 DOI: 10.1080/15299732.2019.1597804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In the present study, 229 major depressive disorder (MDD) patients (57.6% female; 42.4% male) were selected by convenience sampling and examined for rate of dissociative experiences. Research tools were Dissociative Experiences Scale (DES) and demographic questionnaire. Group difference examinations were performed for gender, settlement region (place of residence), and chief complaints using standard t-test, analysis of variance, and Chi-square tests as appropriate. Ordinal regression was implemented for model building. The average age of the sample was 36.78 ± 10.73. Of which, 150 (65.5%) lived in the urban and 79 (34.5%) in the rural areas. The chief complaint of the 146 patients (63.8%) was psychiatric symptoms specific to MDD, and the remaining 83 patients (36.2%) had physical symptoms. The average DES score was 10.59 ± 13.59; and a significant mean DES score differences (P < 0.01) between patients' referred to physician for physical versus psychological complaints (physical: 23.61 ± 14.39; psychological: 3.19 ± 4.5) and geographic settlements (rural: 19.58 ± 15.13; urban: 5.86 ± 9.86) were observed. This study highlights the presence of subtype within MDD patients with significant dissociative tendencies. Given the relationship between trauma history and dissociation, this subgroup could be considered as probable cases with childhood history of abuse, lending to use dissociation as a defense mechanism. Given the evidence for promising results of trauma-focused psychotherapy in treating such patients, paying proper attention to childhood history of depression especially with somatization may minimize pain and suffering of these individuals overtime.
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Affiliation(s)
- Ali Firoozabadi
- a Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Senobar Golshani
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Lila Razeghian
- c Department of Psychiatry , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Somayeh Rahimi
- c Department of Psychiatry , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Amir Ali Sepehry
- d Faculty of Medicine, Division of Neurology , UBC , Vancouver , Canada
| | - Vahid Farnia
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Faezeh Tatari
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Sara Hookari
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Mostafa Alikhani
- b Substance abuse prevention research center , Kermanshah University of Medical Sciences , Kermanshah , Iran
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A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries. BMC Med 2019; 17:17. [PMID: 30764819 PMCID: PMC6376728 DOI: 10.1186/s12916-019-1250-8] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 01/02/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions. METHODS We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations. RESULTS Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes. CONCLUSIONS Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs.
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Acculturative stress in Korean Americans. Appl Nurs Res 2017; 38:70-75. [PMID: 29241523 DOI: 10.1016/j.apnr.2017.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/12/2017] [Accepted: 09/23/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Acculturative stress is known to contribute to chronic diseases among many immigrants and yet this association in Korean Americans remains unclear. AIM The study purpose was to examine the level of acculturative stress in Korean Americans and to determine if correlations existed with personal and physiological factors. METHODS An exploratory, cross-sectional, descriptive study was conducted in a sample of 107 Korean American adults. Data on acculturative stress and personal factors were collected using a survey questionnaire in addition to a direct measure of physiological factors (i.e., body mass index and blood pressure). RESULTS All 107 participants were first-generation Koreans. Most participants were women (66.4%), with a mean age of 53.9±10.7, married (88.8%), and with a college education (84.2%). Acculturative stress was associated with a number of personal factors (i.e., arrival age, years of U.S education, years of U.S. residency, English proficiency), and the personal factors of gender, age, employment status, and years of U.S. residency were associated with the physiological factors. No statistically significant associations were found between acculturative stress and physiological factors. CONCLUSIONS The mean acculturative stress score in this study was higher than findings from prior studies of Korean immigrants in the United States or Canada, with the rates of obesity and hypertension higher than prior reports of Korean Americans or Koreans residing in Korea. Future study is necessary with a larger sample from a variety of different geographic areas of the United States to examine further the impact of acculturative stress on physiological factors during the process of acculturation.
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Thapar-Olmos N, Myers HF. Stigmatizing attributions towards depression among South Asian and Caucasian college students. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1340969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Hector F. Myers
- Department of Psychology, University of California, Los Angeles, USA
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Abstract
The existing literature on Indian ethnopsychology has long asserted that somatization is a key aspect of experiences of distress. The study of idioms of distress arose out of work done in India (Nichter in Cult Med Psychiatry 5(4):379-408, 1981), but ironically, little subsequent work has systematically explored idioms of distress in this part of the world. This ethnographic study focused on the term tension (tenśan) and its relation to a cultural syndrome among women in urban North India. This syndrome appears to involve rapid-onset anger, irritation, rumination, and sleeplessness as key symptoms. It is often linked to specific circumstances such as domestic conflict and is associated with the stresses of modern urban life. People who report more symptoms of tension had consistently higher scores on the Hopkins Symptoms Checklist-25 for depression and anxiety. In this cultural context where psychiatric care is highly stigmatized, the language of tension can aid providers of mental healthcare (many of whom, in India, are not psychiatrists or psychologists) to identify and communicate effectively with potential patients whose mental healthcare needs might otherwise go unaddressed.
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Chang MXL, Jetten J, Cruwys T, Haslam C. Cultural Identity and the Expression of Depression: A Social Identity Perspective. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2016. [DOI: 10.1002/casp.2291] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Jolanda Jetten
- School of Psychology; The University of Queensland; Brisbane Queensland Australia
| | - Tegan Cruwys
- School of Psychology; The University of Queensland; Brisbane Queensland Australia
| | - Catherine Haslam
- School of Psychology; The University of Queensland; Brisbane Queensland Australia
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Aggarwal NK, Pieh MC, Dixon L, Guarnaccia P, Alegría M, Lewis-Fernández R. Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review. PATIENT EDUCATION AND COUNSELING 2016; 99:198-209. [PMID: 26365436 PMCID: PMC4733416 DOI: 10.1016/j.pec.2015.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/04/2015] [Accepted: 09/01/2015] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To describe studies on clinician communication and the engagement of racial/ethnic minority patients in mental health treatment. METHODS Authors conducted electronic searches of published and grey literature databases from inception to November 2014, forward citation analyses, and backward bibliographic sampling of included articles. Included studies reported original data on clinician communication strategies to improve minority treatment engagement, defined as initiating, participating, and continuing services. RESULTS Twenty-three studies met inclusion criteria. Low treatment initiation and high treatment discontinuation were related to patient views that the mental health system did not address their understandings of illness, care or stigma. Treatment participation was based more on clinician language use, communication style, and discussions of patient-clinician differences. CONCLUSION Clinicians may improve treatment initiation and continuation by incorporating patient views of illness into treatment and targeting stigma. Clinicians may improve treatment participation by using simple language, tailoring communication to patient preferences, discussing differences, and demonstrating positive affect. PRACTICE IMPLICATIONS Lack of knowledge about the mental health system and somatic symptoms may delay treatment initiation. Discussions of clinician backgrounds, power, and communication style may improve treatment participation. Treatment continuation may improve if clinicians tailor communication and treatment plans congruent with patient expectations.
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Affiliation(s)
- Neil Krishan Aggarwal
- Columbia University Department of Psychiatry and The Center of Excellence for Cultural Competence at The New York State Psychiatric Institute, New York, USA.
| | - Matthew C Pieh
- Columbia University College of Physicians and Surgeons, New York, USA
| | - Lisa Dixon
- Columbia University Department of Psychiatry and The New York State Psychiatric Institute, New York, USA
| | - Peter Guarnaccia
- Institute for Health. Health Care Policy & Aging Research. Rutgers,The State University of New Jersey, New Brunswick, USA
| | - Margarita Alegría
- Center for Multicultural Mental Health Research and Harvard Medical School, Somerville, USA
| | - Roberto Lewis-Fernández
- Columbia University Department of Psychiatry and The Center of Excellence for Cultural Competence at The New York State Psychiatric Institute, New York, USA
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Roy D, Jayaram G, Vassila A, Keach S, Rao V. Depression after traumatic brain injury: a biopsychosocial cultural perspective. Asian J Psychiatr 2015; 13:56-61. [PMID: 25453532 DOI: 10.1016/j.ajp.2014.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/06/2014] [Accepted: 10/13/2014] [Indexed: 11/29/2022]
Abstract
There are several challenges in diagnosing and treating mental illness amongst South Asians. Often times, formulating a patient's case presentation cannot adequately be accomplished strictly using a biopsychosocial model. The cultural components play an imperative role in explaining certain psychiatric symptoms and can guide treatment. With the growing population of immigrants coming to the United States, many of which require treatment for mental illness, it is essential that clinicians be cognizant in incorporating cultural perspectives when treating such patients. The authors describe the case of a 24-year old South Asian male who suffered an exacerbation of a depressive syndrome after a traumatic brain injury. Using a biopsychosocial cultural approach, this case highlights how South Asian cultural values can contribute to and incite psychiatric symptoms while simultaneously providing protective drivers for treatment outcomes.
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Affiliation(s)
- Durga Roy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA.
| | - Geetha Jayaram
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Alex Vassila
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Vani Rao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
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Disclosure of congenital cleft lip and palate to Japanese patients: reported patient experiences and relationship to self-esteem. BMC Res Notes 2014; 7:924. [PMID: 25515590 PMCID: PMC4302135 DOI: 10.1186/1756-0500-7-924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 12/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study investigated when and how Japanese people with cleft lip and palate (CL/P) learn that their condition is congenital; the perceived effects of withholding the CL/P diagnosis on patients; and whether the resulting social experience and self-esteem are related. A questionnaire survey was conducted in 71 adults with CL/P recruited through a hospital, a patients' association, and by snowball sampling. RESULTS The participants became aware of their physical difference in childhood, but many reported difficulty in understanding their condition. Participants reported that their families avoided the topic of diagnosis. Participants who understood their condition during childhood rather than in adulthood were significantly more likely to consider this scenario as positive (p < 0.001). Although stigmatising experiences were extremely painful, most patients hid their suffering, making it more difficult to obtain social support. Participants with high self-esteem were more likely to feel that they received adequate support. CONCLUSIONS It is important to explain the congenital nature of CL/P sufficiently and early. In addition, openness by the family about the diagnosis, rather than avoidance, may improve patients' self-esteem. Sufficient support from family, health care providers, and significant others is needed for patients to develop adequate self-esteem.
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Abstract
BACKGROUND Coronary heart disease (CHD) is a common and costly condition and is increasing at a higher rate among Asian Indians than among other ethnic groups. An understanding of how Asian Indians perceive their risk is important for health providers to develop culturally appropriate programs to raise awareness of the risk of CHD. OBJECTIVE The aim of this survey was to investigate the attribution of risk factors for CHD among the Asian Indian community in Australia. METHODS Asian Indian community leaders were recruited to provide their views of how their community perceived the risk of CHD. An online survey collected demographic data and information from the Illness Perception Questionnaire-Revised, which measures 6 domains of illness perception: timeline acute/chronic, consequences, emotional impact, personal control, treatment efficacy, and illness comprehension. RESULTS An 84% response rate (n = 49) was achieved from Asian Indian community leaders. Heart disease and cancer were considered to be the illnesses of major concern. Participants indicated that people in their community perceived hereditary factors (90%), hypertension, stress or worry (84%), and aging (86%) as the major cause of their illnesses. Smoking, high blood pressure, and cholesterol were identified as being major risk factors for CHD. CONCLUSIONS These data suggest that as well as strategies to address risk factors such as diet and exercise, stress management is an important issue to consider in developing community-based programs.
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Yang LH, Thornicroft G, Alvarado R, Vega E, Link BG. Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing 'what matters most' to identify culture-specific aspects of stigma. Int J Epidemiol 2014; 43:494-510. [PMID: 24639447 DOI: 10.1093/ije/dyu039] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While stigma measurement across cultures has assumed growing importance in psychiatric epidemiology, it is unknown to what extent concepts arising from culture have been incorporated. We utilize a formulation of culture-as the everyday interactions that 'matter most' to individuals within a cultural group-to identify culturally-specific stigma dynamics relevant to measurement. METHODS A systematic literature review from January 1990 to September 2012 was conducted using PsycINFO, Medline and Google Scholar to identify articles studying: (i) mental health stigma-related concepts; (ii) ≥ 1 non-Western European cultural group. From 5292 abstracts, 196 empirical articles were located. RESULTS The vast majority of studies (77%) utilized adaptations of existing Western-developed stigma measures to new cultural groups. Extremely few studies (2.0%) featured quantitative stigma measures derived within a non-Western European cultural group. A sizeable amount (16.8%) of studies employed qualitative methods to identify culture-specific stigma processes. The 'what matters most' perspective identified cultural ideals of the everyday activities that comprise 'personhood' of 'preserving lineage' among specific Asian groups, 'fighting hard to overcome problems and taking advantage of immigration opportunities' among specific Latino-American groups, and 'establishing trust among religious institutions due to institutional discrimination' among African-American groups. These essential cultural interactions shaped culture-specific stigma manifestations. Mixed method studies (3.6%) corroborated these qualitative results. CONCLUSION Quantitatively-derived, culturally-specific stigma measures were lacking. Further, the vast majority of qualitative studies on stigma were conducted without using stigma-specific frameworks. We propose the 'what matters most' approach to address this key issue in future research.
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Affiliation(s)
- Lawrence Hsin Yang
- Department of Epidemiology, Columbia University, New York, NY, USA, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK, Academic Division in Promotion of Health, School of Public Health, University of Chile Santiago, Chile and Mental Health Association of San Francisco, San Francisco, CA, USA
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Sharma S, Bhui K, Chilcot J, Wellsted D, Farrington K. Identifying depression in South asian patients with end-stage renal disease: considerations for practice. NEPHRON EXTRA 2011; 1:262-71. [PMID: 22470400 PMCID: PMC3290835 DOI: 10.1159/000331446] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Depression is a prevalent burden for patients with end-stage renal disease (ESRD) and one that is under-recognized and consequently under-treated. Although several studies have explored the association between depression symptoms, treatment adherence and outcomes in Euro-American patient groups, quantitative and qualitative exploration of these issues in patients from different cultural and ethnic backgrounds has been lacking. This review discusses the methodological issues associated with measuring depression in patients of South Asian origin who have a 3- to 5-fold greater risk of developing ESRD. There is a need to advance research into the development of accurate screening practices for this patient group, with an emphasis on studies utilizing rigorous approaches to evaluating the use of both emic (culture-specific) and etic (universal or culture-general) screening instruments.
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Affiliation(s)
- Shivani Sharma
- School of Psychology, University of Hertfordshire, Hatfield, UK
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Nieuwsma JA, Pepper CM, Maack DJ, Birgenheir DG. Indigenous perspectives on depression in rural regions of India and the United States. Transcult Psychiatry 2011; 48:539-68. [PMID: 22021105 DOI: 10.1177/1363461511419274] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depression is a major health concern in India, yet indigenous Indian perspectives on depression have often been disregarded in favor of Western conceptualizations. The present study used quantitative and qualitative measures modeled on the Explanatory Model Interview Catalogue (EMIC) to elicit beliefs about the symptoms, causes, treatments, and stigma associated with depression. Data were collected from 92 students at a university in the Himalayan region of Northern India and from 97 students at a university in the Rocky Mountain region of the United States. U.S. participants in this study were included primarily to approximate a "Western baseline" (in which professional conceptions of depression are predominantly rooted) from which to elucidate Indian perspectives. Compared to U.S. participants, Indian participants were more likely to view restive symptoms (e.g., irritation, anxiety, difficulty thinking) as common features of depression, to view depression as the result of personally controllable causes (e.g., failure), to endorse social support and spiritual reflection or relaxation (e.g., yoga, meditation) as useful means for dealing with depression, and to associate stigma with depression. Efforts aimed at reducing depression among Indians should focus more on implementing effective and culturally acceptable interventions, such as yoga, meditation, and increasing social support.
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Affiliation(s)
- Jason A Nieuwsma
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Department of Veterans Affairs-VA- Mid-Atlantic Mental Illness Research, Education and Clinical Center-MIRECC, 508 Fulton Street, Durham, NC 27705, USA.
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Abstract
Despite the benefits of treatment for late-life depression, underutilization of mental health services by older adults and nonadherence to offered interventions exist. This article describes psychosocial and interactional barriers and facilitators of treatment engagement among depressed older adults served by community health care settings. The authors describe the need to engage older adults in treatment using interventions that: (1) target psychological barriers such as stigma and other negative beliefs about depression and its treatment; and (2) increase individuals' involvement in the treatment decision-making process. Personalized treatment engagement interventions designed by the authors' group for various community settings are presented.
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Affiliation(s)
- Patrick J Raue
- Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10605, USA.
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Rao V, Goga J, Inscore A, Kosi R, Khushalani S, Rastogi P, Subramaniam G, Jayaram G. Attitudes towards mental illness and help-seeking behaviors among South Asian Americans: Results of a pilot study. Asian J Psychiatr 2011; 4:76. [PMID: 23050922 DOI: 10.1016/j.ajp.2010.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 08/22/2010] [Accepted: 09/08/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Vani Rao
- Maryland/DC Chapter, Indo-American Psychiatric Association (IAPA), United States
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Raue PJ, Schulberg HC, Lewis-Fernandez R, Boutin-Foster C, Hoffman AS, Bruce ML. Shared decision-making in the primary care treatment of late-life major depression: a needed new intervention? Int J Geriatr Psychiatry 2010; 25:1101-11. [PMID: 19946872 PMCID: PMC2889183 DOI: 10.1002/gps.2444] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We suggest that clinicians consider models of shared decision-making (SDM) for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. METHODS We explore the characteristics and techniques of patient-clinician SDM, with particular emphasis on this model's relevance to the unique treatment concerns of depressed older adults. RESULTS We describe a SDM intervention to engage older adults in depression treatment in the primary care sector. CONCLUSIONS It is timely to examine SDM models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes.
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Affiliation(s)
- Patrick J Raue
- Department of Psychiatry, Weill Cornell Medical College, USA.
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Chakraborty K, Avasthi A, Grover S, Kumar S. Functional somatic complaints in depression: An overview. Asian J Psychiatr 2010; 3:99-107. [PMID: 23051564 DOI: 10.1016/j.ajp.2010.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 06/26/2010] [Accepted: 07/08/2010] [Indexed: 01/01/2023]
Abstract
Depression is a disorder of major public health importance which often manifests through functional somatic complaints. Concept of functional somatic complaints dates back to the time of Wernicke and is later substantiated by various authors. Although considered as an alternative 'idiom of distress' in certain culture, functional somatic complaints are universal. Various international, cross-cultural, inpatient and outpatient based studies have reported that about two-third of subjects of depression present to clinicians with functional somatic complaints which often leads to misrecognition of their illness and in turn leads to increased utilization of health services. These functional somatic complaints can be related to various organ systems but show remarkable homogeneity in their presentation across culture. Various instruments have attempted to tap the functional somatic complaints but are limited by their cross-cultural validity. Among important correlates of functional somatic complaints are female gender, severity of depression, subsyndromal anxiety, alexithymia, somatosensory amplification and hypochondriacal worry are to name a few. Neurobiological understanding implicates neurotransmitters serotonin and norepinephrine, resultantly Serotonin Norepinephrine Reuptake Inhibitors have been found to be effective in treating functional somatic complaints in depression. Future revisions in the nosological systems should consider giving proper importance to some of these symptoms for diagnosing depression.
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Affiliation(s)
- Kaustav Chakraborty
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Oliffe JL, Robertson S, Kelly MT, Roy P, Ogrodniczuk JS. Connecting masculinity and depression among international male university students. QUALITATIVE HEALTH RESEARCH 2010; 20:987-98. [PMID: 20360568 DOI: 10.1177/1049732310365700] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
International university students can experience isolation amid academic pressures. Such circumstances can manifest as or exacerbate depression. This qualitative study involved 15 international male students at a Canadian university who were diagnosed or self-identified as having depression. Individual interviews revealed men's perspectives about causes, implications, and management of depression. Participants intertwined sex- and gender-based factors in detailing causes, and emphasized the potential for parents to impact depression. Implications of depression for embodying traditional masculine roles of breadwinner and career man influenced many men to filter details about their illness within "home" cultures. This practice often prevailed within Canada despite the men's perceptions that greater societal acceptance existed. Masculine ideals underpinned self-management strategies to fight depression and regain control. Counter to men's reluctance to disclose illness details were participants' self-management preference for peer-based support. Study findings highlight how masculine ideals and cultural constructs can influence depression experiences and expressions.
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Affiliation(s)
- John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada.
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Wong YJ, Tran KK, Kim SH, Van Horn Kerne V, Calfa NA. Asian Americans' lay beliefs about depression and professional help seeking. J Clin Psychol 2010; 66:317-32. [PMID: 20127962 DOI: 10.1002/jclp.20653] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Guided by a culturally informed illness representation self-regulation model (CIRSRM), this study analyzed the relations among 223 Asian Americans' lay beliefs about depression, enculturation to Asian values, and their likelihood of seeking professional help for depression. Participants' lay beliefs were assessed through an analysis of written responses to open-ended questions about depression. Enculturation as well as beliefs in biological causes, situational causes, and a short duration of depression were significantly related to the likelihood of professional help seeking. In addition, enculturation moderated the association between several lay beliefs and the endorsement of professional help seeking. The findings are discussed in light of how clinicians can incorporate mental illness lay beliefs in their work with Asian Americans.
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Affiliation(s)
- Y Joel Wong
- Indiana University Bloomington, Bloomington,IN 47405, USA.
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Bryant-Davis T, Chung H, Tillman S, Belcourt A. From the margins to the center: ethnic minority women and the mental health effects of sexual assault. TRAUMA, VIOLENCE & ABUSE 2009; 10:330-57. [PMID: 19578029 DOI: 10.1177/1524838009339755] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The trauma of sexual assault is heightened for many women by the interlocking experience of societal traumas such as racism, sexism, and poverty. The mental health effects of sexual assault are mediated by race and ethnicity. The investigators explore the experiences of African American, Asian American, Latina, and Native American female survivors of sexual assault. The sociohistorical context of intergenerational trauma in the lives of ethnic minorities is a part of the context for the contemporary experience of sexualized violence. Racial and ethnic dynamics related to sexual assault prevalence, mental health effects, and disclosure are examined. Literature related to cultural beliefs, community attitudes, and perceived social support in relation to sexualized violence are also reviewed. Finally, practice, research, and policy implications are discussed.
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Abstract
The 'Barriers to Access to Care for Ethnic Minority Seniors ' (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of 'candidacy', which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.
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Lassetter JH, Callister LC. The impact of migration on the health of voluntary migrants in western societies. J Transcult Nurs 2009; 20:93-104. [PMID: 18840884 DOI: 10.1177/1043659608325841] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The authors reviewed literature on the health of voluntary migrants to Western societies and factors affecting their health. Health indicators include mortality rates and life expectancy, birth outcomes, risk of illness, patterns of deteriorating health, cardiovascular disease, body mass index, hypertension, and depression. Multiple factors explain variability, including length of residence and acculturation, disease exposure, life style and living conditions, risky behaviors, healthy habits, social support networks, cultural and linguistic barriers, experiences with racism, and levels of awareness of cultural health practices among health care providers. Evidence exists for superior health among many migrants to Western countries relative to native-born persons, but the differential disappears over time. Migration is a dynamic, extended process with effects occurring years after physical relocation. Systemic change is required, including health policies that ensure equity for migrants, culturally appropriate health promotion, and routine assessment of migration history, cultural health practices, and disease exposure.
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Brotto LA, Chou AY, Singh T, Woo JST. Reproductive health practices among Indian, Indo-Canadian, Canadian East Asian, and Euro-Canadian women: the role of acculturation. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008; 30:229-238. [PMID: 18364100 DOI: 10.1016/s1701-2163(16)32759-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Lower rates of cervical cancer screening in Indian women have been consistently reported, and this has been attributed to cultural barriers. In Canada, the fastest-growing and largest immigrant groups are South Asian and East Asian. Since traditional values are largely retained in Indo-Canadian immigrants and their children, identifying reproductive health behaviours among these ethnic minority groups is important. Our goal was to compare reproductive health knowledge and behaviours of Indian women living in India and in Canada, East Asian women in Canada, and Euro-Canadian women. We also explored the level of acculturation in the two immigrant groups in order to understand the extent to which affiliation with Western culture may improve reproductive health knowledge. METHODS We recruited 663 women of reproductive age from India and from a Canadian university for assessment. These women completed the Health Beliefs Questionnaire, which measures reproductive health behaviours and knowledge, and the Vancouver Index of Acculturation, which measures the level of mainstream and heritage acculturation. RESULTS Euro-Canadian women were most likely to have ever had a Papanicolaou (Pap) test and to perform breast self-examination (BSE). There was no difference between the two Indian groups in the proportion who had ever had a Pap test, but Indo-Canadian women were more likely to have performed BSE. All women showed knowledge of reproductive health, but the three Canadian groups consistently had more accurate knowledge than the Indian group. Among the two immigrant groups, the level of acculturation was associated with reproductive health knowledge. CONCLUSION Canadian women show reproductive health behaviours and knowledge that is superior to Indian women. Moving to a western culture did not influence Indian women's Pap testing behaviour; however, the fact that the reproductive health knowledge of Indian women who moved to Canada was better than that of women in India suggests that there may be a knowledge-behaviour desynchrony in this group of women. Efforts targeted at ethnic minority groups that aim to improve reproductive health knowledge and behaviours are greatly needed.
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC
| | - Annie Y Chou
- Department of Medicine, University of British Columbia, Vancouver BC
| | - Tara Singh
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC
| | - Jane S T Woo
- Department of Psychology, University of British Columbia, Vancouver BC
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Goldston DB, Molock SD, Whitbeck LB, Murakami JL, Zayas LH, Hall GCN. Cultural considerations in adolescent suicide prevention and psychosocial treatment. AMERICAN PSYCHOLOGIST 2008; 63:14-31. [PMID: 18193978 PMCID: PMC2662358 DOI: 10.1037/0003-066x.63.1.14] [Citation(s) in RCA: 238] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation.
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Affiliation(s)
- David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, Nc 27101, USA.
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Predictors of depression in aging South Asian Canadians. J Cross Cult Gerontol 2007; 23:57-75. [PMID: 17990088 DOI: 10.1007/s10823-007-9051-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Accepted: 10/15/2007] [Indexed: 01/22/2023]
Abstract
This study examined the prevalence and factors of depression among aging South Asians in Canada. Telephone surveys were conducted with a random sample of aging South Asians aged 55 and above. Hierarchical regression analysis was used to determine the factors of depression, which was measured by an adapted 15-item Geriatric Depression Scale. Over one in five (21.4%) participants reported at least a mild level of depression. A stronger agreement with South Asian cultural values was significantly related to a higher probability of being depressed. Physical health variables were the most significant factors after controlling for socio-demographic and culture-related factors. The findings have demonstrated the linkages between the relationships among socio-cultural factors and depression in older South Asians. Mental health interventions should consider the cultural uniqueness of this target population and the service delivery system should ensure that services are known and accessible to the increasingly culturally diverse aging population.
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Szaflarski M, Szaflarski JP, Privitera MD, Ficker DM, Horner RD. Racial/ethnic disparities in the treatment of epilepsy: what do we know? What do we need to know? Epilepsy Behav 2006; 9:243-64. [PMID: 16839821 DOI: 10.1016/j.yebeh.2006.05.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 05/12/2006] [Accepted: 05/26/2006] [Indexed: 11/25/2022]
Abstract
We examine current understanding of the minority disadvantage in the clinical management of epilepsy. We performed an online literature search using several keywords (race, ethnicity, epilepsy, treatment, and quality of life) and identified additional literature through cross-referencing/manual search. The search produced 58 items published between 1977 and 2005. Of 49 original research studies, 38 were quantitative, 7 were qualitative, and 4 used mixed methods. Three or more articles were published in Epilepsia, Epilepsy &Behavior, Epilepsy Research, Neurology, and Seizure. Research concerning racial/ethnic differences in epilepsy treatment is scarce and limited by methodology, but suggests underutilization of state-of-the-art therapies by minorities. Racial/ethnic minorities also appear to have limited knowledge about epilepsy and its treatment, experience barriers to care, lack social support, and seek alternative therapies for epilepsy. We propose a framework to identify the array of disparities, points of intervention, and interventions.
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Affiliation(s)
- Magdalena Szaflarski
- Institute for the Study of Health, University of Cincinnati, Cincinnati, OH, USA.
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Schraufnagel TJ, Wagner AW, Miranda J, Roy-Byrne PP. Treating minority patients with depression and anxiety: what does the evidence tell us? Gen Hosp Psychiatry 2006; 28:27-36. [PMID: 16377362 DOI: 10.1016/j.genhosppsych.2005.07.002] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Revised: 07/13/2005] [Accepted: 07/14/2005] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study is to examine the current state of knowledge regarding treating ethnic/racial minority patients with mood and anxiety disorders, emphasizing data-based studies whenever possible. METHOD This article reviews the evidence on poorer access and quality of care for minorities, the biological and cultural differences between minority and majority populations that may impact care and outcomes, and recent studies that address minority treatment response and outcomes both alone and in comparison to majority groups. RESULTS Numerous impediments to appropriately treating anxious and depressed minority patients remain. Underutilization and poor quality of mental health care in minorities is due to less-than-favorable illness and treatment beliefs that affect adherence and outcome, stigma, clinician failure to engage the patient, poor patient activation and biological differences that may impact pharmacotherapy choice. However, though limited in number, some studies do indicate that when appropriate treatment is well-delivered to minorities, results are comparable to those seen among Caucasian patients. CONCLUSIONS The clinician treating members of minority groups must consider differential personal elements, from the biological to the cultural, to achieve treatment success. The limited available data do suggest that minority patients can be successfully treated with available interventions. Of primary importance is for researchers to increase the number of carefully designed intervention studies that allow for ethnic/racial minority-specific analyses.
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Affiliation(s)
- Trevor J Schraufnagel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, 98104, USA
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