Nativity and DSM-IV Psychiatric Disorders Among Puerto Ricans, Cuban Americans, and Non-Latino Whites in the United States

Center for Multicultural Mental Health Research, Cambridge Health Alliance/ Harvard Medical School, Cambridge, MA, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 02/2006; 67(1):56-65. DOI: 10.4088/JCP.v67n0109
Source: PubMed


This study examined the risk of lifetime substance use disorders and mood and anxiety disorders between Island-born Puerto Ricans, foreign-born Cuban Americans, and foreign-born non-Latino whites and their U.S.-born counterparts.
Data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093) were used to derive lifetime prevalence rates of specific DSM-IV psychiatric disorders by subethnicity and nativity group. Logistic regression models were constructed to detect variation in the odds of each psychiatric disorder across groups.
A protective effect of foreign-born nativity in risk for psychiatric disorders was present for all groups but varied according to the assessed disorder. For non-Latino whites, the effect was observed for most specific psychiatric disorders, whereas, for Puerto Ricans and Cuban Americans, the effect was only evident for specific substance use disorders.
The protective effect of nativity against psychiatric morbidity found in other studies among Mexican Americans and non-Latino whites does not entirely generalize to Puerto Ricans and Cuban Americans and may not generalize to individuals of other origins. The results of this study are discussed in terms of potential mechanisms involved in variations in the risk of specific psychiatric disorders among groups defined by nativity and race-ethnicity and the importance of identifying specific cultural components that may serve as risk and protective factors of psychiatric morbidity.

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    • "Although the prevalence of drug use disorders (DUD) among Hispanics is lower than among non-Hispanic Whites (Huang et al., 2006) the Hispanic population is very heterogeneous and data on overall prevalence may conceal important variations among different Hispanics subgroups. In particular, previous research suggests that the prevalence of psychiatric disorders among Hispanics, especially DUD increases with the degree of acculturation (Alegria et al., 2006, 2007b; Blake et al., 2001; Grant et al., 2004b; Ortega et al., 2000; Turner and Gil, 2002; Vega et al., 1998, 2004). Acculturation refers to the changes that occur as a result of the direct and continuous contact of individuals to a culture different from their own (Redfield et al., 1936). "
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    ABSTRACT: The authors' objective was to examine the relationship between degree of acculturation across five different dimensions of acculturation and risk of drug use disorders (DUD) among US Hispanics. Data were derived from a large national sample of the US adult population, the National Epidemiological Survey on Alcohol and Related Conditions, collected using face-to-face interviews. The sample included civilian non-institutionalized U.S. population aged 18 years and older, with oversampling of Hispanics, Blacks and those aged 18-24 years. Interviews of more than 34,000 adults were conducted during 2004-2005 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule - DSM-IV Version. A total of 6359 subjects who identified themselves as Hispanics were included in this study. Acculturation measures used in this study assessed:, time spent in the U.S., age at immigration, language preference, social network composition, and ethnic identification. Among Hispanics, there was an inverse relationship between five complementary dimensions of acculturation and DUD. Moreover, this relationship showed a significant gradient across all acculturation dimensions and DUD. The prevalence of DUD increases with acculturation in Hispanics, across several measures of acculturation in a dose-response relationship. Hispanic cultural features and values exert a protective effect on risk of DUD. Preservation and promotion of Hispanic values may be an important component of preventive interventions for Hispanics.
    Full-text · Article · Nov 2012 · Journal of Psychiatric Research
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    • "Overall, little is understood about the mental health experiences of Latino immigrants [14] [15]. Given the large number of Latino immigrants and the relevance of immigration status to service provision and to understanding the etiology of mental disorders, a focus on Latino immigrants is both timely and important [8] [16] [17]. Because of the heterogeneity of the Latino population, as the aforementioned reports suggest, there is a need for further research that disaggregates Latino immigrants to explore the nuances of differences in perceptions of depression and mental health services [11] [17] [18]. "
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    ABSTRACT: The Surgeon General's report, "Culture, Race, and Ethnicity: A Supplement to Mental Health," points to the need for subgroup specific mental health research that explores the cultural variation and heterogeneity of the Latino population. Guided by cognitive anthropological theories of culture, we utilized ethnographic interviewing techniques to explore cultural models of depression among foreign-born Mexican (n = 30), Cuban (n = 30), Columbian (n = 30), and island-born Puerto Ricans (n = 30), who represent the largest Latino groups in Florida. Results indicate that Colombian, Cuban, Mexican, and Puerto Rican immigrants showed strong intragroup consensus in their models of depression causality, symptoms, and treatment. We found more agreement than disagreement among all four groups regarding core descriptions of depression, which was largely unexpected but can potentially be explained by their common immigrant experiences. Findings expand our understanding about Latino subgroup similarities and differences in their conceptualization of depression and can be used to inform the adaptation of culturally relevant interventions in order to better serve Latino immigrant communities.
    Full-text · Article · Sep 2011 · Depression research and treatment
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    • "Associations between migration group and alcohol or drug use disorders within the sub-sample of substance users are pursued in an effort to discard that differences in substance use disorders are not simply due to differences in substance use per se, but in the progression from substance use to substance use disorders. We also examined 2 potential sources of selection bias that have hampered prior studies of Hispanics in the United States: (Abraido-Lanza, 1999; Alegria et al., 2006): (1) Are Mexican-born respondents in the CPES (i.e., those who eventually migrate) at greater risk for substance use before immigration than are Mexicans who never immigrated (evidence of mental health–selective migration of persons at risk for substance use)? and (2) are migrants who return to Mexico at higher risk of substance use than migrants who remain in the United States (evidence of selection bias among return migrants, the so-called " salmon bias " hypothesis)? "
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    ABSTRACT: Epidemiologic research has consistently found lower prevalence of alcohol and drug use disorders among Hispanic immigrants to the US than among US-born Hispanics. Recent research has begun to examine how this change occurs in the process of assimilation in the US. We aimed to study immigration, US nativity, and return migration as risk factors for alcohol and drug use among people of Mexican origin in both the US and Mexico. Data come from nationally representative surveys in the United States (2001-2003; n=1208) and Mexico (2001-2002; n=5782). We used discrete time event history models to account for time-varying and time-invariant characteristics. We found no evidence that current Mexican immigrants in the US have higher risk for alcohol or alcohol use disorders than Mexicans living in Mexico, but current immigrants were at higher risk for drug use and drug use disorders. Current Mexican immigrants were at lower risk for drug use and drug disorders than US-born Mexican-Americans. US nativity, regardless of parent nativity, is the main factor associated with increasing use of alcohol and drugs. Among families of migrants and among return migrants we found increased risk for alcohol use, drug use and alcohol and drug use disorders. Evidence of selective migration and return of immigrants with disorders was found regarding alcohol use disorders only. Research efforts that combine populations from sending and receiving countries are needed. This effort will require much more complex research designs that will call for true international collaboration.
    Full-text · Article · Feb 2011 · Drug and alcohol dependence
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