Espinosa Adriana, Gette Jordan A
Department of Psychology, The City College of New York and The Graduate Center, CUNY, New York, USA.
Center of Alcohol & Substance Use Studies & Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA.
J Racial Ethn Health Disparities. 2025 Apr 1. doi: 10.1007/s40615-025-02406-9.
Hispanic/Latin American people comprise a health disparity population, in part due to having higher rates of mental illness relative to White counterparts. Much of the extant literature on understanding Hispanic mental health has focused on single outcomes (e.g., substance use, depression) or single indicators (e.g., adverse childhood experiences). However, given the multifinality of mental health outcomes and their predictors, research is needed to understand how protective and risk factors relate to mental health more broadly (i.e., internalizing and externalizing symptomology). Using a sample of Hispanic adults (N = 7037) who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III, we used structural equation modeling to estimate a correlated common factors model with latent variables for lifetime externalizing and internalizing disorders. Using the discrimination stress, coping, and mental health framework as guide, we examined the associations between latent factor scores, sociodemographic characteristics, and social determinants of health (SDOH). The SDOH included adverse childhood experiences (ACEs), nativity status, ethnic discrimination, ethnic identity, and religiosity/spirituality. Finally, we employed relative importance analyses to assess the comparative importance of significant correlates of psychopathology. ACE was the strongest correlate of both internalizing and externalizing psychopathology, underscoring the importance of prevention and ACEs screening to mitigate adverse mental health outcomes. Discrimination and being US born were the next strongest correlates of having internalizing and externalizing psychopathology. Ethnic identity emerged as the strongest negative correlate of both psychopathology factors. The findings are important for improving Hispanic mental health and informing healthcare policy.
西班牙裔/拉丁裔人群构成了一个健康差距较大的群体，部分原因是与白人相比，他们患有精神疾病的比例更高。目前关于理解西班牙裔心理健康的许多文献都集中在单一结果（如药物使用、抑郁症）或单一指标（如童年不良经历）上。然而，鉴于心理健康结果及其预测因素的多终性，需要进行研究以更广泛地了解保护因素和风险因素与心理健康的关系（即内化和外化症状）。我们以参与第三次全国酒精及相关疾病流行病学调查的7037名西班牙裔成年人作为样本，使用结构方程模型来估计一个具有潜在变量的相关共同因素模型，该模型用于终生外化和内化障碍。以歧视、应对和心理健康框架为指导，我们研究了潜在因素得分、社会人口学特征和健康的社会决定因素（SDOH）之间的关联。SDOH包括童年不良经历（ACEs）、出生地状况、种族歧视、种族认同以及宗教信仰/精神信仰。最后，我们采用相对重要性分析来评估精神病理学显著相关因素的相对重要性。ACE是内化和外化精神病理学的最强相关因素，这凸显了预防和ACEs筛查对减轻不良心理健康结果的重要性。歧视和在美国出生是内化和外化精神病理学的次强相关因素。种族认同是两种精神病理学因素的最强负相关因素。这些发现对于改善西班牙裔心理健康和为医疗政策提供信息具有重要意义。
