Search tips
Search criteria

Results 1-7 (7)

Clipboard (0)

Select a Filter Below

more »
Year of Publication
Document Types
1.  Distal and Proximal Religiosity as Protective Factors for Adolescent and Emerging Adult Alcohol Use 
Religions  2015;6(2):365-384.
Data from emerging adults (ages 18–29, N = 900) in the National Comorbidity Survey Replication Study was used to examine the influence of childhood and emerging adult religiosity and religious-based decision-making, and childhood adversity, on alcohol use. Childhood religiosity was protective against early alcohol use and progression to later abuse or dependence, but did not significantly offset the influence of childhood adversity on early patterns of heavy drinking in adjusted logistic regression models. Religiosity in emerging adulthood was negatively associated with alcohol use disorders. Protective associations for religiosity varied by gender, ethnicity and childhood adversity histories. Higher religiosity may be protective against early onset alcohol use and later development of alcohol problems, thus, should be considered in prevention programming for youth, particularly in faith-based settings. Mental health providers should allow for integration of clients’ religiosity and spirituality beliefs and practices in treatment settings if clients indicate such interest.
PMCID: PMC4486303  PMID: 26146565
addiction; adolescence; alcohol use; childhood adversity; emerging adulthood; religion; spirituality
2.  Retention in Depression Treatment among Ethnic and Racial Minority Groups in the United States 
Depression and anxiety  2010;27(5):485-494.
Premature discontinuation of psychiatric treatment among ethnic-racial minorities is a persistent concern. Prior research on identifying factors associated with ethnic-racial disparities in depression treatment has been limited by the scarcity of national samples with adequate representation of minority groups and especially non-English speakers. In this article we aim to identify variations in the likelihood of retention in depression treatment among ethnic-racial minority groups in the US as compared to non-Latino whites. Secondly, we aim to identify factors which are related to treatment retention.
We use data from the Collaborative Psychiatric Epidemiology Surveys (CPES) to examine differences and correlates of depression treatment retention among a representative sample (n=564) of non-Latino whites, Latinos, African American and Asian respondents with last 12 month depressive disorder and who report receiving formal mental health treatment in the last year. We define retention as attending at least four visits or remaining in treatment over a 12 month period.
Being seen by a mental health specialist as opposed to being seen by a generalist and having received medication are correlates of treatment retention for the entire sample. However, after adjusting for demographics, clinical factors including number of co-occurring psychiatric disorders and level of disability, African Americans are significantly less likely to be retained in depression treatment as compared to non-Latino whites.
Availability of specialized mental health services or comparable treatment within primary care could improve treatment retention. Low retention suggests persistent problems in the delivery of depression treatment for African Americans.
PMCID: PMC2927223  PMID: 20336808
Depression; Retention in Care; Ethnic-Racial Minorities
3.  Prevalence and Correlates of Lifetime Suicidal Ideation and Attempts among Latino Subgroups in the United States 
Limited data is available to understand the prevalence and correlates of suicidal behavior among U.S. Latino subgroups. This paper compares the prevalence of lifetime suicide ideation and suicide attempts among major U.S. Latino ethnic subgroups and identifies psycho-sociocultural factors associated with suicidal behaviors.
The National Latino and Asian American Study (NLAAS) includes Spanish and English speaking Mexicans, Puerto Ricans, Cubans and other Latinos. Descriptive statistics and logistic models were used to determine demographic, clinical, cultural and social correlates of lifetime suicide ideation and attempts.
The lifetime prevalence of suicidal ideation and attempts among Latinos was 10.2% and 4.4%, respectively. Puerto Ricans were more likely to report ideation as compared to other Latino subgroups but this difference was eliminated after adjustments for psychiatric and sociocultural factors. Most lifetime suicidal attempts described by Latinos were reported as occurring when they were under the age of 18 years. Any lifetime DSM-IV diagnoses, including dual diagnoses, were associated with an increased risk of lifetime suicidal ideation and attempts among Latinos. In addition, female gender, acculturation (born in U.S. and English speaking) and high levels of family conflict were independently and positively correlated with suicide attempts among Latinos, even among those without any psychiatric disorder.
These findings reinforce the importance of understanding the process of acculturation, the role of family and sociocultural context for suicide risk among Latinos. These should be considered in addition to psychiatric diagnoses and symptoms in Latino suicide research, treatment and prevention, especially among young individuals.
PMCID: PMC2774123  PMID: 17474813
4.  Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States 
Ethnicity & health  2008;13(5):435-463.
We present the prevalence of political violence (PV) of immigrant Latinos in the US, and perceived need for and correlates of mental health services use among this population.
We use the National Latino and Asian American Study (NLAAS), a nationally representative epidemiological survey of US Latinos, including a probability sample of 1630 immigrant Latinos. We use a conceptual framework that assumes a strong role of social and cultural factors in understanding the risk for psychopathology and mental health service use.
Eleven percent of all immigrant Latinos reported PV exposure and 76% described additional lifetime traumas. Among those with a history of PV, an increased likelihood of using mental health services was associated with female gender, English language proficiency, experiencing personal assaults, higher perceived discrimination, and having an anxiety or substance disorder. Specific subgroups of Latinos, including men and Mexican immigrants, were less likely to access mental health services after experiencing PV. Perceived need for mental health services use is the strongest correlate of any lifetime and last 12 months service use.
The strong consequences of PV suggest the need for systematic screening and referral strategies. Specific outreach interventions focused on perceptions of need could be helpful for subgroups of Latinos including men who are particularly underrepresented in mental health services but who exhibit significant trauma histories.
PMCID: PMC2771411  PMID: 18850369
political violence; Latino; immigrant; trauma; mental health services use
5.  Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder across Ethnic and Racial Minority Groups in the U.S 
Medical care  2013;51(12):1114-1123.
We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of traumatic events (PTEs) among a nationally representative U.S. sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.
PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.
Asians have lower prevalence rates of probable lifetime PTSD while African Americans have higher rates as compared to non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared to non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors or differences in types and frequencies of PTEs across groups.
There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.
PMCID: PMC3922129  PMID: 24226308
Posttraumatic Stress Disorders across racial and ethnic minority groups; diagnosis
6.  Childhood Trauma and Psychiatric Disorders as Correlates of School Dropout in a National Sample of Young Adults 
Child development  2011;82(3):982-998.
The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S. born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys (CPES), a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2532 young adults, ages 21 to 29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relationship between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout.
PMCID: PMC3089672  PMID: 21410919
7.  A Qualitative Study of Clinicians’ Use of the Cultural Formulation Model in Assessing Posttraumatic Stress Disorder 
Transcultural psychiatry  2009;46(3):429-450.
The Cultural Formulation of Diagnosis (CFD) Model of the Diagnostic and Statistical Manual (DSM) provides a potential framework for improving the diagnostic assessment of Posttraumatic Stress Disorder (PTSD) in culturally diverse patients. We analyzed data from the Patient-Provider Encounter Study, a multisite study that examines the process of diagnosis and clinical decision-making during an initial clinical intake session, in order to examine use of CFD for PTSD diagnosis. We find that the use of the CFD in routine community settings is inconsistently or underutilized in practice, but when employed may assist the formulation and interpretation of traumatic experiences. We discuss the implications for improving the assessment of PTSD in the time-limited setting of the clinical intake encounter and across race/ethnicity.
PMCID: PMC2879977  PMID: 19837780
Posttraumatic Stress Disorder; Cross-Cultural Diagnosis; Trauma; Clinical Decision Making; Cultural Formulation Model

Results 1-7 (7)