This article is more than 5 years old. Information may no longer be current.

Research identifies predictors of mental health illness among blacks, Hispanics; develops screening tool

Two recently published studies identified specific environmental factors that predicted depression, anxiety and PTSD among low-income black and Hispanic Americans and developed a screening tool for clinical assessment based on those factors.

“Extensive mental and physical health disparities exist among racial/ethnic groups. Many theories have been proposed to explain the robustness of these ethnic-based differences, including psychosocial stress models that suggest that minorities experience unique stressors that strongly impact health… [including] discrimination based on ethnicity and having multiple traumatic experiences,” study researcher Hector F. Myers, PhD, of Vanderbilt University, and colleagues wrote in Psychological Trauma. “The need for research to guide prevention and intervention efforts to reduce these disparities is particularly relevant for African Americans and Latinos who carry a disproportionally high burden of physical and mental health disorders.”

Hector F. Myers

To determine if lifetime cumulative adversities and trauma predicted mental health symptoms of depression, anxiety and PTSD, Myers and colleagues evaluated 500 black and Hispanic adults with low socioeconomic status who completed a standard battery of self-reports on stress and mental health. The mean age of the study participants was 39 years. Approximately 74% of the study cohort had incomes at or below $1,249 per month and 77.23% were unemployed.

Study participants reported severe histories of child sexual abuse, with men reporting more severe levels of child sexual abuse than women, according to researchers. Hispanic women had the lowest levels of child sexual abuse severity.

Black study participants reported significantly more adult sexual abuse than Hispanics, though Hispanic men had significantly higher reports of adult sexual abuse vs. Hispanic women.

Study participants reported experiencing high levels of discrimination due to ethnicity. Black study participants reported more discriminatory experiences than Hispanics, with black women reporting the highest levels and Hispanic women reporting the lowest.

Structural equation modeling indicated a correlation between the cumulative burden of adversities and trauma (ie, experiencing discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma and chronic stresses) and risk for psychological distress later in life.

Gail Wyatt

“Only a small proportion of individuals with psychological distress are identified in health care settings and a smaller fraction of those ever receive appropriate treatment, especially for the experiences of discrimination,” study researcher Gail Wyatt, PhD, of the University of California, Los Angeles, said in a press release. “We talk about being discriminated against, but people don’t learn how to cope with it effectively throughout their lives. If they don’t manage it well enough, the consequences can be long-lasting and life-threatening.”

In an effort to better identify adverse effects of discrimination among patients and potentially prevent long-term effects, Honghu Liu, PhD, of the University of California, Los Angeles, and colleagues utilized these study findings to create a new screening tool for use in clinical settings.

Honghu Liu

The UCLA Life Adversities Screener, also referred to as LADS, is a brief questionnaire that assesses lifetime experiences of discrimination due to racial, ethnic, gender or sexual orientation, a history sexual abuse, family or intimate partner violence, community violence and a chronic fear of being killed or severely injured, to help providers offer more accurate treatment for stress and trauma.

“Given the utility and ease of use, LADS could be effective as a screening tool to identify ethnic and racial minority individuals in primary care settings who have a high trauma burden, and who need more extensive evaluation," Liu said in the release. “We feel it will capture experiences that could be missed with current screening approaches. This could optimize affordable care as it strives to improve prevention of mental health problems.”

According to Wyatt, the Affordable Care Act offers a unique opportunity to identify patients who have not been assessed for stress or trauma due to limited health care coverage, and these study findings could provide tools needed to complete that process. – by Amanda Oldt

Disclosure: Healio.com/Psychiatry was unable to confirm relevant financial disclosures at the time of publication.