A community survey of psychological impairment among Anglo- and Mexican Americans and its relationship to service utilization

Discussions of Mexican American mental health need have been limited to analyses of service utilization statistics, most of which have shown Mexican Americans to use mental health services proportionally less than other racial/ethnic groups. Consequently, Mexican Americans have been viewed as a group having greater unmet mental health needs. Yet, these utilization-based needs assessments make an implicit and untested assumption: that the proportion of the psychologically impaired is comparable across racial/ethnic groups. The purpose of the present investigation was, first, to contribute to a baseline measurement of psychological impairment among Mexican Americans in order to assess what utilization should be for this group and, second, to determine relationships between impairment symptomatology and sociodemographic characteristics which are unique to the Mexican American population. Anglo- and Mexican Americans (n=515) living in one of three suburban communities in Southern California were selected by way of a random-digit, multistage cluster telephone sampling procedure. Respondents gave responses to a standardized measurement of psychological impairment. Results showed that Anglo- and Mexican Americans did not differ in anxiety, psychosocial dysfunction, and depressive symptoms. Mexican Americans in the three communities, however, were found to use mental health services proportionally less than Anglos. Relationships between age and psychosocial dysfunction symptoms, and between income and anxiety problems were different for Mexican Americans than those for Anglos. Issues related to what constitutes mental health need and the use of self-report measures of impairment to estimate mental health need across culturally diverse groups are discussed.     

Marital status and depression among Mexican Americans

Summary Using data from a three-generations study of Mexican Americans in San Antonio, the authors found that, in general, women and unmarried (widowed or divorced-separated) persons had significantly higher scores on the CES-D depression scale than men and married persons even after a number of controls were introduced. However, marital status did not matter in the older generation and divorce-separation lost significance in the third generation after the controls. The authors discuss the findings in light of the place of the elderly in the Mexican American family and in light of rising divorce rates in younger generations.Funded by grant AG04170 from the National Institute on Aging and by a grant from the Hogg Foundation for Mental Health     

Acculturation and self-esteem among older Mexican Americans

Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N=3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.     

Emotional distress and needs for psychosocial support among breast cancer patients at start of radiotherapy

Radiotherapy is considered to be associated with psychological distress in cancer patients. The present pilot study was aimed at exploring both emotional distress and support needs among patients with primary breast cancer. 77 women were evaluated at the start of radiotherapy after completion of their breast-conserving surgical treatment. Emotional distress was measured with the Hospital Anxiety and Depression Scale and the Hornheider Questionnaire. Needs for additional psychosocial support as well as acceptance of support were assessed by single items. In addition to the patients' views, ratings from physicians, nurses and technical assistants were obtained. Although according to their self-reports only one third of the patients wished to talk about their disease and almost all of them had sufficient opportunities for discussions with their family members, 36 % reported needs for additional support and 75 % said that they would be willing to accept support in the case that it would be offered to them. Emotional distress and support needs were rated even higher by the members of the medical team. 20 % of the patients had high values (> 10) on the anxiety subscale and 5 % had high values (> 10) on the depression subscale of the HADS. 37 % were distressed according to the Hornheider Questionnaire. However, neither the HADS nor the Hornheider Questionnaire were sufficiently sensitive and specific to detect those patients reporting support needs. It was concluded that better screening tools have to be developed for identifying breast cancer patients in need of psychosocial support during radiotherapy.     

Risk factors for mild cognitive impairment among Mexican Americans

BackgroundAlthough a great deal of literature has focused on risk factors for mild cognitive impairment (MCI), little published work examines risk for MCI among Mexican Americans.MethodsData from 1628 participants (non-Hispanic n = 1002; Mexican American n = 626) were analyzed from two ongoing studies of cognitive aging and Alzheimer's disease, Project FRONTIER (Facing Rural Obstacles to health Now Through Intervention, Education & Research) and TARCC (Texas Alzheimer's Research & Care Consortium).ResultsWhen looking at the full cohorts (non-Hispanic and Mexican American), age, education, Apolipoprotein E (APOE) ε4 status and gender were consistently related to MCI diagnosis across the two cohorts. However, when split by ethnicity, advancing age was the only significant risk factor for MCI among Mexican Americans across both cohorts.ConclusionsThe current data suggest that many of the previously established risk factors for MCI among non-Hispanic cohorts may not be predictive of MCI among Mexican Americans and point to the need for additional work aimed at understanding factors related to cognitive aging among this underserved segment of the population.     

Marital support,psychological distress,and disability among community-dwelling older couples: A longitudinal study

Little is known about the relationship between marital support, psychological distress and disability among older couples. Overall, it appears that functional status (the presence or absence of disability) has a major effect on psychological distress. The aim of this study is to explore longitudinally the relationship between functional status, marital support and psychological distress. This study was carried out over a period of 18 months using a representative sample of 394 community-dwelling couples, aged 65 and over. The following instruments were used: the Perceived Supportive Spouse Behaviors Questionnaire, the Index of Psychological Distress and a structured interview designed to measure disability. A dyadic longitudinal design was used to test the mediating effect of marital support on the relationship between disability and psychological distress in older couples. Dyadic data analyses with structural equation modeling were performed. The results indicate that neither positive nor negative marital support has any mediating effect on the relationship between functional status and psychological distress. However, it also indicates that negative marital support of men and women is related to their level of psychological distress. Moreover, both men and women react to even a slight decrease in their functional autonomy with an increase in psychological distress.     

Depression and anxiety among Mexican Americans in a family health center

Summary A standardized interview including parts of the NIMH-Diagnostic Interview Schedule was used to determine the prevalence of depression (major depression or dysthymia) and generalized anxiety in a random sample of predominantly low-income Mexican American patients attending an inner-city family health center. Overall rates of current DSM-III-diagnosable depression and anxiety were similar to rates reported for other primary care patient populations in the United States. There were racial/ethnic and sex differences in the rates of these disorders, with Anglo females having disproportionately high rates. Among women, the rate of mental disorders was higher for those with many somatic symptoms, three or more children, low scores on a scale of family integration, and numerous missed appointments in the last year.     

Anxiety disorders among Mexican Americans and non-Hispanic whites in Los Angeles

This report from the Los Angeles site of the NIMH Epidemiologic Catchment Area study reveals significant ethnic and national origin differences in lifetime prevalence rates for three out of six specific, DSM-III-defined anxiety disorders. In the case of simple phobia, United States-born Mexican Americans report higher rates than native non-Hispanic whites or immigrant Mexican Americans, the latter two groups having similar rates. Mexican Americans born in the United States had higher rates of agoraphobia than immigrant Mexican Americans, and non-Hispanic whites reported higher lifetime rates of generalized anxiety disorder compared with both immigrant and native Mexican Americans. Neither ethnic nor national origin differences in lifetime prevalence rates were found for panic disorder, social phobia, and obsessive-compulsive disorder. Selective migration is postulated as a potential factor influencing prevalence differences between native and immigrant Mexican Americans.     

Emotional distress among spouses of psychiatric outpatients in Holland

Interviews with spouses of individually referred psychiatric outpatients reveal relevant complaints about the ways the spouses have been approached by previous psychotherapists of their patient-partner. Suggestions are given to incorporate these complaints into efficient strategies for the involvement of spouses in the treatment of the patients.     

Development of psychological distress among young adults.

Persons with high scores on psychiatric screening scales appear frequently in general medical settings, psychiatric outpatient clinics, and other agencies providing assistance, but there is considerable controversy concerning the appropriate interpretation of high scores on such scales obtained in community epidemiological studies. Data are presented from a 16-year follow-up study of children, first studied in 1961, examining developmental aspects of achieving high scores on such scales. Data come from the children themselves, their mothers, teachers, and school records. The findings are consistent with the hypothesis that such generalized distress reports are in part a learned pattern of illness behavior involving a focus on internal feeling states, careful monitoring of body sensations, and a high level of self-awareness.     

Predicting psychological distress among former Soviet immigrants.

This study investigated whether age, gender, marital status, education, employment, length of time in the U.S. and immigration demands (novelty, occupation, language, discrimination, loss, and not feeling at home) were predictors of psychological distress in a sample of 1,647 former Soviet immigrants. Multiple regression analysis indicated that the combined model of demographic and demand of immigration variables was significant. Results indicated that women, older immigrants, those with less than a college education, and those with greater immigration demands related to novelty, language, discrimination, loss, and not feeling at home were most distressed.     

Patterns of suicide among Mexican Americans and Anglos, 19602–1980

Summary Little is known about suicidal behavior among Mexican Americans, the second largest and most rapidly growing ethnic group in the United States. This paper reports trends in suicide rates for Mexican Americans and Anglos in Bexar County (San Antonio), Texas, over a 20-year period of time. Results show that suicide rates for Mexican Americans of both sexes are substantially lower than those for Anglos from 1960 to 1980. Suicide rates for both ethnic groups increased over time, but rates for Ang los increased more than rates for Mexican Americans. Unique aspects of Mexican American culture are offered to explain the findings.An earlier draft of this paper was presented at the World Congress of Sociology, Mexico City, 20 August 1982. The research was supported by an Institutional Research Grant from The University of Texas Health Science Center at San Antonio.     

Life stress, social support and psychological distress in late adolescence

Psychological distress in high-school students was examined in relation to negative life events, long-lasting adversities and perceived social support from the family, friends and the school class. Academic problems increased the symptom levels of psychological distress, and social support from family and social support from friends reduced the symptoms among males and females. For females, social support from school class-mates and problems with parents and friends also had direct independent effects on symptom levels. An effect of the total number of long-lasting adversities was significantly stronger for females than males. The buffer hypothesis was supported: both an increase in social support from parents and social support from peers reduced the effect of negative life events.     

Extended family and friendship support and suicidality among African Americans

Purpose

This study examined the relationship between informal social support from extended family and friends and suicidality among African Americans.

Methods

Logistic regression analysis was based on a nationally representative sample of African Americans from the National Survey of American Life (N = 3263). Subjective closeness and frequency of contact with extended family and friends and negative family interaction were examined in relation to lifetime suicide ideation and attempts.

Results

Subjective closeness to family and frequency of contact with friends were negatively associated with suicide ideation and attempts. Subjective closeness to friends and negative family interaction were positively associated with suicide ideation and attempts. Significant interactions between social support and negative interaction showed that social support buffers against the harmful effects of negative interaction on suicidality.

Conclusions

Findings are discussed in relation to the functions of positive and negative social ties in suicidality.

     

Social support buffers young men's resilient coping to psychological distress

Aim

Social support and resilient coping can aid mental health. The aim of this study was to examine age effects of social support on men's resilient coping for psychological distress.

Methods

The sample consisted of 434 help-seeking Canadian men who completed standardized measures. Regression analyses tested a moderated moderation model, controlling for COVID-19 pandemic impact.

Results

Greater resilient coping was associated with lower psychological distress and this relationship was moderated by social support. Higher levels of social support had a significant positive effect on men's resilient coping for psychological distress. Findings indicated that younger men (18–24 years) were most positively buffered by social support.

Conclusions

Social support appears to be particularly important for young men's coping response to psychological distress. This is an important finding in the context of the COVID-19 pandemic, where social support networks have been challenged. Community-based and clinical programs and initiatives that proactively target young men's development of social connections and robust supportive networks, while bolstering their individual resilient coping skills, are likely to provide protections from psychological distress.     

Suicide, negative interaction and emotional support among black Americans

Objectives

This study is the first to investigate the relationship between perceived emotional support and negative interaction with family members and suicide ideation and attempts among African American and Caribbean black adults.

Method

Cross-sectional epidemiologic data from the National Survey of American Life and multivariable logistic regression analyses were used to examine the association between perceived emotional support and negative interaction and suicide behaviors among 3,570 African Americans and 1,621 Caribbean blacks age 18 and older.

Results

Multivariate analyses found that perceived emotional support was associated with lower odds of suicide ideation and attempts for African Americans and Caribbean blacks. Negative interaction with family was associated with greater odds of suicide ideation among African Americans and Caribbean blacks. Ethnicity moderated the impact of emotional support and negative interaction on suicide attempts; among Caribbean blacks, those who reported more frequent emotional support from their family had a significantly greater reduced risk for suicide attempts than African Americans. The effect of negative interaction on suicide attempts was also more pronounced for Caribbean blacks compared to African Americans.

Discussion

Negative interaction was a risk factor for suicide ideation and emotional support was a protective factor for attempts and ideation. These associations were observed even after controlling for any mental disorder. The findings demonstrate the importance of social relationships as both risk and protective factors for suicide and ethnic differences in suicidal ideation and attempts among black Americans.     

Ischemic stroke subtypes among Mexican Americans and non-Hispanic whites: the BASIC Project

Ischemic stroke subtype distribution was compared between Mexican Americans (MAs) and non-Hispanic whites (NHWs) in a community-based stroke surveillance study in Nueces County, TX. There was no difference in the distribution of stroke subtype by ethnicity (p = 0.19). There was a similar proportion of small-vessel and large-artery strokes between the two ethnic groups (p = 0.32). Differences in stroke rates among MAs and NHWs are not explained by the distribution of ischemic stroke subtypes.     

Somatic sensations and psychological distress among students in Britain and Pakistan

This is a cross-cultural study reporting the prevalence of somatic sensations in matched populations of students in Leeds (U.K.) and Lahore (Pakistan). A new self-report questionnaire, the Bradford Somatic Inventory (BSI), was employed together with the General Health Questionnaire (GHQ-28). There was no statistically significant difference between the two populations in mean endorsement rates but females from both ethnic groups demonstrated a higher prevalence of reported somatic sensations and had higher GHQ scores than males. The frequency hierarchy of endorsed items was similar in both groups. This study provides no support for the notion that Asian subjects generally experience more somatic sensations associated with psychological distress than Western subjects. Differences in the endorsement rates of particular items were evident and these are discussed.