OBJECTIVE: Depression is a major debilitating disease. For American Indians living in tribal reservations, who endure disproportionately high levels of stress and poverty often associated with depression, determining the patterns and correlates is key to appropriate clinical assessment and intervention development. Yet little attention has been given to the cultural context of correlates for depression, including the influence of family, cultural traditions or practices, or community conditions. METHOD: We used data from a large representative psychiatric epidemiological study among American Indians in 2 reservation communities to estimate nested individual and multilevel models of past-year major depressive episode (MDE) accounting for family, cultural, and community conditions. RESULTS: We found that models including culturally informed individual-level measures significantly improved the model fit over demographics alone. We found significant community-level variation in the probability of past-year MDE diagnosis in 1 tribe even after accounting for individual-level characteristics. CONCLUSIONS: Accounting for culture, family, and community context will facilitate research, clinician assessment, and treatment of depression in diverse settings.
OBJECTIVE:Depression is a major debilitating disease. For American Indians living in tribal reservations, who endure disproportionately high levels of stress and poverty often associated with depression, determining the patterns and correlates is key to appropriate clinical assessment and intervention development. Yet little attention has been given to the cultural context of correlates for depression, including the influence of family, cultural traditions or practices, or community conditions. METHOD: We used data from a large representative psychiatric epidemiological study among American Indians in 2 reservation communities to estimate nested individual and multilevel models of past-year major depressive episode (MDE) accounting for family, cultural, and community conditions. RESULTS: We found that models including culturally informed individual-level measures significantly improved the model fit over demographics alone. We found significant community-level variation in the probability of past-year MDE diagnosis in 1 tribe even after accounting for individual-level characteristics. CONCLUSIONS: Accounting for culture, family, and community context will facilitate research, clinician assessment, and treatment of depression in diverse settings.
Authors: Emily Woltmann; Andrew Grogan-Kaylor; Brian Perron; Hebert Georges; Amy M Kilbourne; Mark S Bauer Journal: Am J Psychiatry Date: 2012-08 Impact factor: 18.112
Authors: Janette Beals; Spero M Manson; Nancy R Whitesell; Paul Spicer; Douglas K Novins; Christina M Mitchell Journal: Arch Gen Psychiatry Date: 2005-01
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Doreen Koretz; Kathleen R Merikangas; A John Rush; Ellen E Walters; Philip S Wang Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Lisa G Dirks; Jaedon P Avey; Vanessa Y Hiratsuka; Denise A Dillard; Karen Caindec; Renee F Robinson Journal: Am Indian Alsk Native Ment Health Res Date: 2018
Authors: Melissa Walls; Kelley J Sittner; Les B Whitbeck; Kaley Herman; Miigis Gonzalez; Jessica H L Elm; Dane Hautala; Melinda Dertinger; Dan R Hoyt Journal: Int J Ment Health Addict Date: 2020-06-08 Impact factor: 3.836
Authors: Jacques Philip; Tove K Ryman; Scarlett E Hopkins; Diane M O'Brien; Andrea Bersamin; Jeremy Pomeroy; Kenneth E Thummel; Melissa A Austin; Bert B Boyer; Kirk Dombrowski Journal: PLoS One Date: 2017-11-01 Impact factor: 3.240