Katie A McLaughlin1, Kiara Alvarez2, Mirko Fillbrunn2, Jennifer Greif Green3, James S Jackson4, Ronald C Kessler5, Ekaterina Sadikova5, Nancy A Sampson5, Corrie L Vilsaint6, David R Williams7, Margarita Alegría2. 1. Department of Psychology, Harvard University, Cambridge, MA, USA. 2. Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 3. Wheelock College of Education & Human Development, Boston University, Boston, MA, USA. 4. Department of Psychology, University of Michigan, Ann Arbor, MI, USA. 5. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 6. Recovery Research Institute, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 7. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: The prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities. METHODS: We estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%). RESULTS: TE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence - particularly being a refugee - but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in organized violence, sexual violence, and other TEs, Latinos had the highest exposure to physical violence, and Whites were most likely to experience accidents/injuries. Racial/ethnic minorities had lower odds ratios of depression, anxiety, and substance disorder onset relative to Whites. Neither variation in TE exposure nor vulnerability to psychopathology following TEs across racial/ethnic groups explained these differences. Vulnerability to PTSD did vary across groups, however, such that Asians were less likely and Blacks more likely to develop PTSD following TEs than Whites. CONCLUSIONS: Lower prevalence of mental disorders among racial/ethnic minorities does not appear to reflect reduced vulnerability to TEs, with the exception of PTSD among Asians. This highlights the importance of investigating other potential mechanisms underlying racial/ethnic differences in psychopathology.
BACKGROUND: The prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities. METHODS: We estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%). RESULTS:TE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence - particularly being a refugee - but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in organized violence, sexual violence, and other TEs, Latinos had the highest exposure to physical violence, and Whites were most likely to experience accidents/injuries. Racial/ethnic minorities had lower odds ratios of depression, anxiety, and substance disorder onset relative to Whites. Neither variation in TE exposure nor vulnerability to psychopathology following TEs across racial/ethnic groups explained these differences. Vulnerability to PTSD did vary across groups, however, such that Asians were less likely and Blacks more likely to develop PTSD following TEs than Whites. CONCLUSIONS: Lower prevalence of mental disorders among racial/ethnic minorities does not appear to reflect reduced vulnerability to TEs, with the exception of PTSD among Asians. This highlights the importance of investigating other potential mechanisms underlying racial/ethnic differences in psychopathology.
Authors: Teresa A Lillis; John Burns; Frances Aranda; Helen J Burgess; Yanina A Purim-Shem-Tov; Stephen Bruehl; Jean C Beckham; Linzy M Pinkerton; Stevan E Hobfoll Journal: J Behav Med Date: 2019-12-12
Authors: Sarah E Valentine; Luana Marques; Ye Wang; Emily M Ahles; Louise Dixon De Silva; Margarita Alegría Journal: Gen Hosp Psychiatry Date: 2019-10-23 Impact factor: 3.238
Authors: Tiffany R Glynn; Noelle A Mendez; Deborah L Jones; Sannisha K Dale; Adam W Carrico; Daniel J Feaster; Allan E Rodriguez; Steven A Safren Journal: J Behav Med Date: 2020-10-24