Latino Men and Depression: An Exploratory Study of Help-Seeking Behavior

描述(申请人提供)：抑郁症是最普遍和致残的精神疾病之一，有证据表明，低收入的拉丁裔可能面临特别高的风险经历这种障碍。然而，在这一群体中，正规精神卫生服务的利用率非常低，特别是在文化适应程度较低或新移民中。拉美裔男性可能尤其面临服务利用不足的风险，因为他们是少数群体，而且受到禁止为生活问题寻求帮助的男性性别规范的影响。鉴于美国拉美裔人口的快速增长，研究人员澄清拉美裔男性利用治疗的障碍至关重要。到目前为止，还没有研究检查文化和性别相关变量，这些变量预测了这一人群对心理健康治疗和寻求治疗行为的态度。我们建议对低收入拉丁裔男性抑郁治疗未得到充分利用的基于文化和性别的心理变量进行首次系统调查。这项研究的长期目标是确定可以如何修改或加强现有治疗的具体方法，使其对拉美裔男性更具吸引力和相关性，最终改善这些男性对护理的使用。这项研究将利用定量和定性方法，以经历临床上明显抑郁症症状的低收入拉丁裔男性为样本。量化部分将包括120名拉丁裔男性(60名正在接受治疗，60名没有接受治疗)，他们将在两个时间点完成访谈和自我报告评估，评估寻求治疗行为的各种预测因素，包括对心理健康治疗的态度、耻辱和感知的护理障碍。此外，量化部分的中心焦点将是衡量基于文化和性别的心理变量，我们预测这些变量将与更接近的求医行为预测因素相关。定性部分将包括对大约24名拉丁裔男子的个别访谈，重点是了解寻求抑郁症治疗的决定所依据的过程，以及文化和性别在寻求治疗过程中的作用。本次调研的具体研究目的是： (1)了解低收入拉丁裔男性对抑郁、应对抑郁和抑郁治疗的概念 (2)识别和了解低收入拉丁裔男性在考虑寻求抑郁症治疗时遇到的促进因素和障碍 (3)探讨特定的文化心理变量和性别心理变量对低收入拉丁裔男性抑郁寻求治疗的影响 (4)开发一个初步模型，说明文化和性别相关变量如何影响低收入拉丁裔男性解释抑郁症状以及选择寻求或不寻求治疗的方式。 抑郁症是最普遍和最致残的精神疾病之一，但治疗利用率仍然很低，特别是在低收入少数群体中。拉丁裔男性在需要时不寻求心理健康服务的风险尤其高。这项研究旨在澄清许多低收入拉丁裔男性在抑郁时不寻求帮助的原因，从而为改善对这一高危群体的服务奠定基础。

DESCRIPTION (provided by applicant): Depression is one of the most prevalent and disabling psychiatric disorders, and evidence suggests that low-income Latinos may be at particularly high risk for experiencing the disorder. However, utilization of formal mental health services is very low in this population, especially among less acculturated or recent immigrants. Latino men may be especially at risk for underutilizing services, due to both their minority status and the impact of masculine gender norms that proscribe seeking help for problems in living. Given the rapidly increasing growth in the Latino population in the US, it is critical for researchers to clarify barriers to treatment utilization in Latino men. To date, no research has examined the cultural and gender-related variables that predict attitudes towards mental health treatment and treatment-seeking behavior in this population. We propose to conduct the first systematic investigation of the culture- and gender-based psychological variables underlying the underutilization of depression treatment by low-income, Latino men. The long-term goal of this research is to identify specific ways in which current treatments can be modified or enhanced to make them more appealing and relevant to Latino men, ultimately improving the use of care by these men. This study will utilize quantitative and qualitative methodology and will target a sample of low-income Latino men experiencing clinically significant symptoms of depression. The quantitative portion will consist of 120 Latino men (60 who are currently in treatment, and 60 who are not) who will complete interview and self-report assessments at two time points measuring a variety of predictors of treatment-seeking behavior, including attitudes toward mental health treatment, stigma, and perceived barriers to care. In addition, a central focus of the quantitative portion will be to measure culture- and gender-based psychological variables that we predict will be associated with the more proximal predictors of treatment-seeking behavior. The qualitative portion will consist of individual interviews with approximately 24 Latino men and will focus on understanding the processes by which decisions to seek treatment for depression are made, and the role that culture and gender play in the treatment-seeking process. The specific research aims of this investigation are: (1) To understand how low-income Latino men conceptualize depression, coping with depression, and depression treatment (2) To identify and understand the facilitative factors and barriers that low-income Latino men experience when considering seeking treatment for depression (3) To explore the ways that specific culturally-based and gender-based psychological variables influence depression treatment-seeking in low-income Latino men (4) To develop a preliminary model of how culture and gender-related variables influence the ways in which low-income Latino men interpret depressive symptoms and choose to seek or not seek treatment. Depression is one of the most prevalent and disabling psychiatric disorders, yet treatment utilization rates remain very low, especially among low-income minorities. Latino men are at a particularly heightened risk for not seeking mental health services when needed. This study is designed to clarify reasons why many low-income Latino men do not seek help when they are depressed, thus providing the groundwork for improved services for this high risk group.