Illness Conceptualizations Among Older Rural Mexican-Americans with Anxiety and Depression

Abstract

Background Research on barriers and utilization of mental health services in older ethnic minorities has been productive. However, little is known about the characterization and beliefs about anxiety and depression symptoms among older Mexican-Americans. Exploration of these conceptualizations will lead to better detection and provision of care to this large, yet underserved group. Method The present study used a mixed methods approach to explore conceptualizations of anxiety and depression in a group of rural older Mexican-Americans. Twenty-five Spanish-speaking participants (mean age 71.2) responded to flyers that solicited individuals who felt “tense or depressed.” Participants completed a structured diagnostic interview as well as self-report questionnaires about medical health, anxiety and depressive symptoms, and cognitive functioning. Qualitative interviews included questions about how participants describe, conceptualize, and cope with anxiety and depression symptoms. Results Sixty-eight percent of the sample met criteria for at least one anxiety or mood disorder with high comorbidity rates. Self-reported symptoms of depression, anxiety, and somatization were below clinical ranges for all participants. Medical illness, cognitive impairment, age, education, and acculturation were not associated with distress. Qualitative analyses revealed that nearly half of the terms used by the sample to describe distress phenomena deviated from Western labels traditionally used to indicate anxious and depressive symptomatology. Discussion Multiple methods of symptom endorsement demonstrated that older Mexican-Americans may report distress differently than detected by traditional self-report measures or common Western terminology. Understanding these additional illness conceptualizations may have implications for improving the detection of mental illness and increasing service use among this growing population.

Differences in anxiety and depression symptoms: comparison between older and younger clinical samples

“…Only one study to date has previously done something similar to investigate differences in Hispanic older adults (Letamendi et al, 2013). Only one study to date has previously done something similar to investigate differences in Hispanic older adults (Letamendi et al, 2013).…”

“…Similar to the method used in the study of Letamendi et al (2013), symptoms descriptors were read out by the interviewer and participants were asked to indicate which words they would use to describe their worry or anxiety, followed by sadness or feeling down. The anxiety list included 15 words such as worry, nervous, concerned, and scared, and had an adequate internal consistency (Cronbach's α: total sample = 0.70, younger = 0.69, older = 0.68).…”

“…The depressive list included 19 words such as sad, flat , and unmotivated , and had an adequate internal consistency (Cronbach's α : total sample = 0.73, younger = 0.78, older = 0.63). Similar to the method used in the study of Letamendi et al (2013), symptoms descriptors were read out by the interviewer and participants were asked to indicate which words they would use to describe their worry or anxiety, followed by sadness or feeling down.…”

“…It has previously been reported that older adults are less likely to endorse sadness as a symptom of depression, but it is unclear if they would be more likely to endorse alternatives such as flatness or feeling down. stress or nervous) and reported fewer somatic symptoms (Letamendi et al, 2013). A recent study with older Hispanic adults used a checklist to examine differences in the way that older Hispanics described their worry and found that they rarely endorsed common idioms used in Western cultures to describe anxiety (e.g.…”

"We can’t carry the weight of the whole world": Illness experiences among Peruvian older adults with symptoms of depression and anxiety

“…Because depression and anxiety frequently co-exist and may not be clearly differentiated by general public (13), we considered both. Few studies have explored the perceptions of depression or anxiety in older adults from Latin America (14,15). In three recent systematic reviews of qualitative studies about depression in older adults, none included populations from Latin America (16)(17)(18).…”