Showing papers by "Harold W. Neighbors published in 2007"
TL;DR: When MDD affects African Americans and Caribbean blacks, it is usually untreated and is more severe and disabling compared with that in non-Hispanic whites, and the burden of mental disorders may be higher among US blacks than in US whites.
Abstract: Context Little is known about the relationship between race/ethnicity and depression among US blacks. Objective To estimate the prevalence, persistence, treatment, and disability of depression in African Americans, Caribbean blacks, and non-Hispanic whites in the National Survey of American Life. Design A slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview. Setting National household probability samples of noninstitutionalized African Americans, Caribbean blacks, and non-Hispanic whites in the United States conducted between February 2, 2001, and June 30, 2003. Participants A total of 3570 African Americans, 1621 Caribbean blacks, and 891 non-Hispanic whites aged 18 years and older (N = 6082). Main Outcome Measures Lifetime and 12-month diagnoses of DSM-IV major depressive disorder (MDD), 12-month mental health services use, and MDD disability as quantified using the Sheehan Disability Scale and the World Health Organization's Disability Assessment Schedule II. Results Lifetime MDD prevalence estimates were highest for whites (17.9%), followed by Caribbean blacks (12.9%) and African Americans (10.4%); however, 12-month MDD estimates across groups were similar. The chronicity of MDD was higher for both black groups (56.5% for African Americans and 56.0% for Caribbean blacks) than for whites (38.6%). Fewer than half of the African Americans (45.0%) and fewer than a quarter (24.3%) of the Caribbean blacks who met the criteria received any form of MDD therapy. In addition, relative to whites, both black groups were more likely to rate their MDD as severe or very severe and more disabling. Conclusions When MDD affects African Americans and Caribbean blacks, it is usually untreated and is more severe and disabling compared with that in non-Hispanic whites. The burden of mental disorders, especially depressive disorders, may be higher among US blacks than in US whites.
1,119 citations
TL;DR: Increased exposure to minority status in the United States was associated with higher risks for psychiatric disorders among Black Caribbean immigrants, which possibly reflects increased societal stress and downward social mobility associated with being Black in America.
Abstract: Objectives. We examined the prevalence of psychiatric disorders among Black Caribbean immigrant (“Caribbean Black”) and African American populations and the correlates of psychiatric disorders among the Caribbean Black population.Methods. We conducted descriptive and age-adjusted analyses of the data from the National Survey of American Life—an in-person household mental health survey of noninstitutionalized US Blacks. We assessed psychiatric disorders as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria with the Composite International Diagnostic Interview.Results. Compared with African American men, Caribbean Black men had higher risks for 12-month rates of psychiatric disorders. Caribbean Black women had lower odds for 12-month and lifetime psychiatric disorders compared with African American women. Risks varied by ethnicity, immigration history, and generation status within the Caribbean sample. First-generation Caribbean Blacks had lower rates of psychiatric di...
364 citations
TL;DR: The underuse of mental health services among black Americans remains a serious concern and educational interventions that focus on both consumers and mental health care professionals are needed.
Abstract: Context Little is known about differences in the unmet need for mental health service use between African Americans and Caribbean blacks. Objective To extend the National Survey of Black Americans by examining 12-month mental health service use for African Americans and Caribbean blacks from the recently completed National Survey of American Life. Design and Setting National household probability samples of noninstitutionalized African Americans and Caribbean blacks (blacks from Caribbean area countries now living in the United States) conducted between February 2001 and June 2003, using a slightly modified World Mental Health version of the World Health Organization's Composite International Diagnostic Interview. Participants A total of 3570 African Americans and 1621 Caribbean blacks 18 years and older (N = 5191). Main Outcome Measures Proportion of respondents with 12-month DSM-IV disorders who sought help in the specialty mental health, general medical, human service, and complementary-alternative medicine treatment sectors. The percentage receiving minimally adequate treatment was also assessed. Results Overall, 10.1% of respondents used some form of mental heath care services in the past year. Use of services was much higher among those who met criteria for a 12-month DSM-IV disorder (31.9%) than among those who did not (5.4%). Forty-nine percent of respondents with serious mental illness used services, whereas 39.3% had contact with mental health care specialists. The youngest and oldest age groups were least likely to obtain any services. Among African Americans, women were more likely than men to use general medical care and services from any sector. Respondents with the most years of education showed the highest use of services. Conclusions The underuse of mental health services among black Americans remains a serious concern. Educational interventions that focus on both consumers and mental health care professionals are needed.
344 citations
TL;DR: The findings suggest that timing of migration and generational status of Caribbean Black immigrants and ancestry groups contribute to important differences in rates and sources of use, relative satisfaction, and perception of helpfulness, with regard to formal mental health services.
Abstract: Objectives. We examined the use rates and correlates of formal psychiatric services among the US-born and immigrant Caribbean Black population.Methods. We compared overall mental health service use in samples of Caribbean Blacks and African Americans and examined the within-sample ethnic variation among Caribbean Blacks, including for ethnic origin (Spanish Caribbean, Haiti, and English Caribbean), nativity status (those born in or outside the United States), number of years spent living in the United States, age at the time of immigration, and generational status.Results. African Americans and Caribbean Blacks used formal mental health care services at relatively low rates. Among Caribbean Blacks, generational status and nativity showed the greatest effects on rates of reported use, satisfaction, and perceived helpfulness. Of those study participants who met the criteria for disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, about one third used formal ment...
168 citations
TL;DR: Both black groups were more likely to rate their MDD as severe or very severe and more disabling compared with that in non-Hispanic whites, and the burden of mental disorders, especially depressive disorders, may be higher among US blacks than in US whites.
Abstract: Context: Little is known about the relationship between race/ethnicity and depression among US blacks. Objective: To estimate the prevalence, persistence, treatment, and disability of depression in African Americans, Caribbean blacks, and non-Hispanic whites in the National Survey of American Life. Design: A slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview. Setting: National household probability samples of noninstitutionalized African Americans, Caribbean blacks, and non-Hispanic whites in the United States conducted between February 2, 2001, and June 30, 2003. Participants: A total of 3570 African Americans, 1621 Caribbean blacks, and 891 non-Hispanic whites aged 18 years and older (N=6082). Main Outcome Measures: Lifetime and 12-month diagnoses of DSM-IV major depressive disorder (MDD), 12-month mental health services use, and MDD disability as quantified using the Sheehan Disability Scale and the World Health Organization’s Disability Assessment Schedule II. Results: Lifetime MDD prevalence estimates were highest for whites (17.9%), followed by Caribbean blacks (12.9%) and African Americans (10.4%); however, 12- month MDD estimates across groups were similar. The chronicity of MDD was higher for both black groups (56.5% for African Americans and 56.0% for Caribbean blacks) than for whites (38.6%). Fewer than half of the African Americans (45.0%) and fewer than a quarter (24.3%) of the Caribbean blacks who met the criteria received any form of MDD therapy. In addition, relative to whites, both black groups were more likely to rate their MDD as severe or very severe and more disabling. Conclusions: WhenMDDaffects African Americans and Caribbean blacks, it is usually untreated and is more severe and disabling compared with that in non-Hispanic whites. The burden of mental disorders, especially depressive disorders, may be higher among US blacks than in US whites.
143 citations
TL;DR: Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder and the most prevalent 12-month disorders were PTSD, major depression, and social phobia.
Abstract: Objective The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans. Methods Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM–IV) psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, dysthymia, bipolar I and II disorders, alcohol abuse/dependence, and drug abuse/dependence). Results Twenty-three percent of older African Americans reported at least one lifetime disorder and 8.54% reported at least one 12-month disorder. Alcohol abuse, PTSD, and major depression were the most prevalent lifetime disorders. The most prevalent 12-month disorders were PTSD, major depression, and social phobia. Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder. Conclusion This is the first study of prevalence rates of serious mental disorders for older African Americans based on a national sample. Demographic correlates of the prevalence of disorders are discussed with an emphasis on age and regional differences.
82 citations
TL;DR: Focus groups were used to explore the complexities of the Black male experience and capture young Black men's understanding of and comfort with discussing their mental health.
65 citations
TL;DR: Data from the adult reinterview portion of the National Survey of American Life is used to investigate the relationships of John Henryism Active Coping Scale, Social Dominance, and Stratification beliefs to depressive symptoms as measured by the Center for Epi-demiologic Studies Depression Scale.
Abstract: We used data from the adult reinterview portion of the National Survey of American Life (Jackson, Torres, et al., 2004) to investigate the relationships of John Henryism Active Coping Scale (James, Hartnett, & Kalsbeek, 1983), Social Dominance, and Stratification Beliefs to depressive symptoms as measured by the Center for Epi-demiologic Studies Depression Scale (Radloff, 1977). Social Dominance and Stratification Beliefs (American Values) were identified from a factor analysis. The results indicate significant interaction effects for John Henryism and American Values for White Americans and Caribbean Blacks but not for African Americans. We found a strong positive effect between John Henryism and depressive symptoms for Whites with high levels of Stratification Beliefs. For Whites with low Stratification Beliefs, depressive symptoms remained constant as John Henryism increased. Among Caribbean Blacks, John Henryism showed a significant interaction with Social Dominance. Among Caribbean Blacks, there was ...
59 citations
TL;DR: Content analysis of narratives from 13 focus groups revealed significant overlap in the range of concerns for which people seek support and those issues for which they will not seek ministerial help.
Abstract: This focus group study examines the use of ministerial support among African American adults with regard to (1) the issues taken to ministers by church members, (2) the issues not taken to ministers by church members, and (3) the factors that inform people's decisions about whether or not to seek ministerial support. Content analysis of narratives from 13 focus groups revealed significant overlap in the range of concerns for which people seek support and those issues for which they will not seek ministerial help. The factors that influence peoples' decisions included shame as well as evaluations of minister character, sincerity, and skill set. Narrative examples are used to elucidate each theme, and the implications of the findings for theory, research, and practice are discussed.
52 citations