Conceptual Models of Depression in Latino Outpatients

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DESCRIPTION (provided by applicant): The candidate described in this application is a clinical psychologist with a background in qualitative health research. The purpose of the application is to prepare the candidate for an independent career focusing on mental health research in primary care and community setting. Specific goals for the study include 1) improving skills in quantitative design and analysis; 2) acquiring expertise in developing mixed method studies; and 3) acquiring familiarity with problems and methods in the field of mental health research. Training activities include a combination of formal coursework, a research apprenticeship, and mentoring by a panel of expert consultants. In addition, the candidate will carry out a series of three small-scale mixed-methods pilot studies with the goal of developing a measure and generating hypotheses for future studies. During the award period, a hypothesis testing study which will be developed as an R01 application. The candidate's interests have been shaped by her experiences as a practicing psychotherapist, as well as a longstanding attraction to the methods and perspectives of psychiatric anthropology. The proposed studies examine primary care patients' conceptual representations of depression and investigate the relationship of their representations to treatment seeking preferences. Research shows that many depressed patients, especially low-income and minority patients, do not receive effective treatment for these disorders in primary care settings. Few studies have investigated how patients interpret their illness and make decisions about treatment, and none have examined in detail the effects of acculturation on patients' models of illness and care. Drawing on a model of the cognitive representation of illness from the health psychology literature, the exploratory studies proposed in the application seek to 1) describe depressed patients' conceptual models of their illness, 2) examine the influence of acculturation and SES on these models; and 3) examine the role of these models in shaping treatment preferences and behaviors. The current study focuses on Latino primary care patients, a focus of interest for the investigator both in prior research and in her clinical work.