Conceptual Models of Depression in Latino Outpatients

描述(由申请人提供)：本申请表中描述的候选人是一名具有定性健康研究背景的临床心理学家。申请的目的是为候选人独立的职业生涯做好准备，专注于初级保健和社区环境中的精神卫生研究。这项研究的具体目标包括1)提高定量设计和分析的技能；2)获得开发混合方法研究的专业知识；3)熟悉心理健康研究领域的问题和方法。培训活动包括正式课程、研究学徒和专家顾问小组的指导。此外，候选人将进行一系列三个小规模的混合方法试点研究，目的是为未来的研究制定一种衡量标准和产生假设。在获奖期间，一项假设检验研究将作为R01应用程序开发。这位候选人的兴趣来自于她作为一名执业心理治疗师的经历，以及对精神人类学方法和视角的长期吸引力。这项研究考察了初级保健患者对抑郁的概念表征，并调查了他们的表征与寻求治疗偏好的关系。研究表明，许多抑郁症患者，特别是低收入和少数族裔患者，在初级保健环境中得不到这些疾病的有效治疗。很少有研究调查患者如何解释他们的疾病并做出治疗决定，也没有研究详细检查文化适应对患者疾病和护理模式的影响。根据健康心理学文献中的疾病认知表征模型，本申请中提出的探索性研究试图1)描述抑郁症患者对其疾病的概念模型，2)考察文化适应和社会支持对这些模型的影响，3)考察这些模型在塑造治疗偏好和行为方面的作用。目前的研究重点是拉丁裔初级保健患者，这是研究人员在先前的研究和临床工作中感兴趣的焦点。

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.