Asian Americans' Depressive Experiences and Mental Health Service Use Behaviors: Considering Physical Symptomatology

depressive;somatic;service use;dropout;symptomatology;Asian;Psychology;Social Sciences;Psychology

Kim, JacquelineKing, Cheryl A ;

University of Michigan

关键词: depressive;    somatic;    service use;    dropout;    symptomatology;    Asian;    Psychology;    Social Sciences;    Psychology;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/138778/jhjkim_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

As rates of depression continue to increase, problems with mental health service underutilization and premature termination from psychotherapy remain unresolved. This has been most notable for ethnic minority groups in the United States—with Asian Americans showing the greatest mental health service use disparity for over a decade. Asian Americans’ use of mental health services, including psychotherapy, may be influenced by the type of depressive symptom experience. In particular, physical symptoms in Asian Americans;; distress, such as pain, may differentiate: (a) the mental health services sought for relief, and (b) retention in psychotherapy. This dissertation is composed of two studies using different analytical approaches to examine the role of physical depressive symptomatology in Asian Americans’ mental health service use behaviors.First, data from 890 National Latino and Asian American Study (NLAAS) participants were quantitatively analyzed to identify symptoms that characterize Asian Americans’ depressive experiences. Then, the relationship between symptom experience and various forms of mental health service utilization was examined. Since the symptom experience may not only influence services sought but also how a person interacts in a psychotherapy setting, the second study analyzed 36 patients’ archival data from an outpatient clinic to explore Asian American psychotherapy dropout. The relevance of physical depressive symptomatology was included in this primarily qualitative examination. The first quantitative study revealed that some experiences fit well within established DSM-defined criteria for depression, while others are better characterized by physical symptoms found in culturally salient idioms of distress. After considering other known predictors of mental health service use, depressive experiences characterized by chronic physical symptoms predicted specific forms of mental health service use (alternative care/self-help and psychological counseling/therapy). The second qualitative mixed-method study gave rise to themes related to psychotherapy dropout and demonstrated that most patients described physical symptoms as part of their depressive distress. However, the clinician-documented physical symptom emphasis did not relate to an early drop from or longer stay in outpatient psychotherapy. Overall, results from this dissertation indicated a presence of heterogeneity in Asian Americans’ depressive experiences, with physical symptoms being an important part of the experience for some Asian Americans. Structural barriers influenced both the utilization of mental health services and retention in psychotherapy, after accounting for the symptom experience. Implications for clinical services and future research are discussed.