Letamendi Andrea M, Ayers Catherine R, Ruberg Joshua L, Singley Daniel B, Wilson Jacqueline, Chavira Denise, Palinkas Lawrence, Wetherell Julie Loebach
J Cross Cult Gerontol. 2013 Dec;28(4):421-33. doi: 10.1007/s10823-013-9211-8.
Research on barriers and utilization of mental health services in older ethnic minorities has been productive. However, little is known about the characterization and beliefs about anxiety and depression symptoms among older Mexican-Americans. Exploration of these conceptualizations will lead to better detection and provision of care to this large, yet underserved group. The present study used a mixed methods approach to explore conceptualizations of anxiety and depression in a group of rural older Mexican-Americans. Twenty-five Spanish-speaking participants (mean age 71.2) responded to flyers that solicited individuals who felt “tense or depressed.” Participants completed a structured diagnostic interview as well as self-report questionnaires about medical health, anxiety and depressive symptoms, and cognitive functioning. Qualitative interviews included questions about how participants describe, conceptualize, and cope with anxiety and depression symptoms. Sixty-eight percent of the sample met criteria for at least one anxiety or mood disorder with high comorbidity rates. Self-reported symptoms of depression, anxiety, and somatization were below clinical ranges for all participants. Medical illness, cognitive impairment, age, education, and acculturation were not associated with distress. Qualitative analyses revealed that nearly half of the terms used by the sample to describe distress phenomena deviated from Western labels traditionally used to indicate anxious and depressive symptomatology. Multiple methods of symptom endorsement demonstrated that older Mexican-Americans may report distress differently than detected by traditional self-report measures or common Western terminology. Understanding these additional illness conceptualizations may have implications for improving the detection of mental illness and increasing service use among this growing population.
对老年少数族裔心理健康服务的障碍及利用情况的研究成果丰硕。然而，对于老年墨西哥裔美国人对焦虑和抑郁症状的认知及看法却知之甚少。探究这些概念化认知将有助于更好地发现并为这个庞大但未得到充分服务的群体提供护理。本研究采用混合方法，探讨一组农村老年墨西哥裔美国人对焦虑和抑郁的概念化认知。25名讲西班牙语的参与者（平均年龄71.2岁）回应了招募“感到紧张或抑郁”者的传单。参与者完成了结构化诊断访谈以及关于身体健康、焦虑和抑郁症状及认知功能的自我报告问卷。定性访谈包括关于参与者如何描述、概念化及应对焦虑和抑郁症状的问题。68%的样本符合至少一种焦虑或情绪障碍的标准，共病率很高。所有参与者自我报告的抑郁、焦虑和躯体化症状均低于临床范围。医疗疾病、认知障碍、年龄、教育程度和文化适应与痛苦无关。定性分析显示，样本中用于描述痛苦现象的术语近一半与传统上用于表示焦虑和抑郁症状的西方标签不同。多种症状认可方法表明，老年墨西哥裔美国人报告痛苦的方式可能与传统自我报告测量或常见西方术语所检测到的不同。了解这些额外的疾病概念化认知可能对改善精神疾病的发现及增加这一不断增长的人群对服务的使用有影响。
