Conceptual Models of Depression in Latino Outpatients

描述（由申请人提供）：本申请中描述的候选人是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在初级保健和社区环境中从事精神卫生研究的独立职业做好准备。该研究的具体目标包括：1)提高定量设计和分析的技能；2)获得发展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，候选人将开展一系列三个小规模混合方法的试点研究，目的是为未来的研究开发一种测量方法并产生假设。在奖励期间，将进行一项假设检验研究，该研究将作为R01应用程序开发。这位候选人的兴趣来源于她作为心理治疗师的实践经历，以及对精神人类学方法和观点的长期吸引力。提出的研究检查初级保健患者的抑郁症的概念表征，并调查他们的表征与治疗寻求偏好的关系。研究表明，许多抑郁症患者，特别是低收入和少数民族患者，在初级保健机构中没有得到有效的治疗。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。基于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旨在1)描述抑郁症患者对其疾病的概念模型，2)检验文化适应和社会经济地位对这些模型的影响；3)检查这些模型在形成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，这是研究者在之前的研究和临床工作中都感兴趣的焦点。

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.