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Ronald C Kessler - One of the best experts on this subject based on the ideXlab platform.
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barriers to mental health service use and predictors of treatment drop out racial ethnic variation in a population based study
Administration and Policy in Mental Health, 2020Co-Authors: Jennifer Greif Green, Ronald C Kessler, Katie A Mclaughlin, Mirko Fillbrunn, Marie Fukuda, James S Jackson, Ekaterina Sadikova, Nancy A Sampson, Corrie L Vilsaint, David R WilliamsAbstract:This study examines racial/ethnic differences in perceived need for mental health treatment, barriers to treatment receipt, and reasons for dropout. Data are from the Collaborative Psychiatric Epidemiology Studies, a pooled dataset from three U.S. nationally-representative adult samples. Among respondents with a 12-month Psychiatric disorder who received no treatment (N = 1417), Asians and Latinos reported lower perceived need than Blacks and Whites, and Latinos reported the fewest attitudinal barriers. Among those with a 12-month disorder who dropped out of treatment, Asians and Latinos gave more reasons for dropping out. Significant interactions of race/ethnicity with other characteristics identified subpopulations with high unmet need.
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racial and ethnic differences in individual level and area based socioeconomic status and 12 month dsm iv mental disorders
Journal of Psychiatric Research, 2019Co-Authors: Ruijia Chen, Ronald C Kessler, Jennifer Greif Green, Katie A Mclaughlin, Ekaterina Sadikova, Nancy A Sampson, Corrie L Vilsaint, Amanda Nemoyer, Kiara Alvarez, James S JacksonAbstract:Abstract The purpose of this study was to: (1) examine the associations of individual-level objective socioeconomic status (OSS), subjective socioeconomic status (SSS), and area-based indicators of socioeconomic status, with 12-month DSM-IV mood, anxiety, alcohol use, and drug use disorders; and, (2) determine the extent of racial/ethnic differences in these associations across non-Latino White, non-Latino Black, Latino, and Asian participants. Data are from the Collaborative Psychiatric Epidemiology Studies dataset, a collection of three population-based surveys of mental disorders among U.S. residents aged 18 and older (n = 13,775). Among all indicators of socioeconomic status, SSS was most consistently associated with 12-month mental disorders. Income was negatively associated with mood and anxiety disorders; education was negatively associated with alcohol use and drug use disorders. Significant interactions with race/ethnicity were found for the associations of socioeconomic indicators with anxiety, alcohol use, and drug use disorders but not with mood disorders. SSS was not associated with any of the 12-month mental disorders among Blacks. Education had stronger associations with 12-month anxiety and alcohol use disorders among Whites than among other racial/ethnic groups. Among Asians, low income compared to high income was associated with a lower risk of anxiety disorders and less than high school completion compared to college or more was associated with a lower risk of alcohol use disorders. Finally, tract-level income inequality was associated with a greater risk of drug use disorders only among Blacks. The patterns and magnitudes of the associations of individual-level and area-based socioeconomic indicators differed by type of disorder and race/ethnicity.
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Epidemiology of anxiety disorders from surveys to nosology and back
Dialogues in clinical neuroscience, 2017Co-Authors: Dan J Stein, Kate M. Scott, Peter De Jonge, Ronald C KesslerAbstract:On the basis of epidemiological survey findings, anxiety disorders are the most prevalent mental disorders around the world and are associated with significant comorbidity and morbidity. Such surveys rely on advances in Psychiatric nosology and may also contribute usefully to revisions of the nosology. There are a number of questions at the intersection of Psychiatric Epidemiology and nosology. This review addresses the following: What is the prevalence of anxiety disorders and how do we best explain cross-national differences in prevalence estimates? What are the optimal diagnostic criteria for anxiety disorders, and how can epidemiological data shed light on this question? What are the comorbidities of anxiety disorders, and how do we best understand the high comorbidities seen in these conditions? What is the current treatment gap for anxiety disorders, and what are the implications of current understandings of Psychiatric Epidemiology and nosology for policy-making relevant to anxiety disorders? Here, we emphasize that anxiety disorders are the most prevalent of the Psychiatric conditions, and that rather than merely contrasting cross-national prevalence in anxiety disorders, it is more productive to delineate cross-national themes that emerge about the Epidemiology of these conditions. We discuss that optimizing diagnostic criteria for anxiety disorders is an iterative process to which epidemiological data can make a crucial contribution. Additionally, high comorbidity in anxiety disorders is not merely artefactual; it provides key opportunities to explore pathways to mental disorders and to intervene accordingly. Finally, work on the Epidemiology and nosology of anxiety disorders has provided a number of important targets for mental health policy and for future integrative work to move between bench and bedside, as well as between clinic and community.
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overview of descriptive Epidemiology of mental disorders
2013Co-Authors: Ronald C KesslerAbstract:Epidemiology is the study of the distribution and correlates of illness in the population. The three stages of epidemiological investigation are descriptive, analytic, and experimental. Descriptive Epidemiology is concerned with the distribution of illness onset and course, whereas analytic Epidemiology is concerned with the use of nonexperimental data to elucidate causal processes involved in illness onset and course, and experimental Epidemiology is concerned with the development and evaluation of interventions aimed at modifying risk factors to prevent illness onset or to modify illness course. Most epidemiological studies of Psychiatric disorders are either descriptive or analytic. Historically, much of the important work in these areas has been done by sociologists. Experimental Psychiatric Epidemiology is more rare. A challenge for sociologists working in Psychiatric Epidemiology is to refine their analytic models sufficiently to establish the basis for structural interventions. See Rothman (1986) for an introduction to Epidemiology overall and Tsaung, Tohen, and Zahner (1995) for an introduction to Psychiatric Epidemiology.
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lifetime risk and persistence of Psychiatric disorders across ethnic groups in the united states
Psychological Medicine, 2005Co-Authors: Joshua Breslau, Kenneth S Kendler, Sergio Gaxiolaaguilar, Ronald C KesslerAbstract:Background Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in Psychiatric Epidemiology, patterns of Psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample.
Margarita Alegria - One of the best experts on this subject based on the ideXlab platform.
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neighborhood context and substance use disorders a comparative analysis of racial and ethnic groups in the united states
Drug and Alcohol Dependence, 2012Co-Authors: Kristine M Molina, Margarita Alegria, Chihnan ChenAbstract:Abstract Background There is evidence that ethnic/racial minorities are conferred differential risk for substance use problems based on where they live. Despite a burgeoning of research focusing on the role of neighborhood characteristics on health, limited findings are available on substance use. Our study uses nationally representative data ( N = 13,837) to examine: (1) what neighborhood characteristics are associated with risk of substance use disorders?; (2) do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors? Methods Data were drawn from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file) with 836 census tracts. Analyses included African Americans, Asians, Caribbean Blacks, Latinos, and non-Latino whites. Separate logistic regression models were fitted for any past-year substance use disorder, alcohol use disorder, and drug use disorder. Results Living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when we investigated the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. We also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity. Conclusions Characteristics of the environment might represent differential risk for substance disorders depending on a person's ethnicity/race and nativity status.
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childhood trauma and Psychiatric disorders as correlates of school dropout in a national sample of young adults
Child Development, 2011Co-Authors: Michelle V Porche, Lisa R Fortuna, Julia Lin, Margarita AlegriaAbstract:The effect of childhood trauma, Psychiatric diagnoses, and mental health services on school dropout among U.S.-born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys, a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2,532 young adults, aged 21-29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood Psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relation between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of Psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout.
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mental health care for ethnic minority individuals and communities in the aftermath of disasters and mass violence
Cns Spectrums, 2005Co-Authors: Fran H Norris, Margarita AlegriaAbstract:Findings from research on Psychiatric Epidemiology, disaster effects, discrepancies in service use, and cross-cultural psychology are reviewed to generate guidelines for culturally responsive postdisaster interventions. Ethnicity and culture influence mental health care at various points: on need for help; on availability and accessibility of help; on help-seeking comfort (stigma, mistrust), and on the probability that help is provided appropriately. There are aspects of disaster mental health practice that may ameliorate many of barriers that contribute to ethnic disparities in service use. It is proposed that interventions should give greater attention to socially engaged emotions and functioning. To promote disaster recovery, practitioners are advised to: assess community needs early and often; provide easily accessible services; work collaboratively and proactively to reduce stigma and mistrust and engage minorities in care; validate and normalize distress and help-seeking; value interdependence as well as independence as an appropriate developmental goal; promote community action; and advocate for, facilitate, or conduct treatment and evaluation research. Notwithstanding the pain and stress they cause, disasters create opportunities to de-stigmatize mental health needs and build trust between providers and minority communities.
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cultural relevance and equivalence in the nlaas instrument integrating etic and emic in the development of cross cultural measures for a Psychiatric Epidemiology and services study of latinos
International Journal of Methods in Psychiatric Research, 2004Co-Authors: Margarita Alegria, Peter J. Guarnaccia, Glorisa Canino, Sergio Aguilargaxiola, Doryliz Vila, David T Takeuchi, Mildred Vera, Vivian Febo, Patrick E ShroutAbstract:This paper describes the development, translation and adaptation of measures in the National Latino and Asian American Study (NLAAS). We summarize the techniques used to attain cultural relevance; semantic, content and technical equivalency; and internal consistency of the measures across languages and Latino sub-ethnic groups. We also discuss some of the difficulties and challenges encountered in doing this work. The following three main goals are addressed in this paper: (1) Attaining cultural relevance by formulating the research problem with attention to the fundamental cultural and contextual differences of Latinos and Asians as compared to the mainstream population; (2) Developing cultural equivalence in the standardized instruments to be used with these populations; and (3) Assessing the generalizability of the measures –i.e., that the measures do not fluctuate according to culture or translation. We present details of the processes and steps used to achieve these three goals in developing measures for the Latino population. Additionally, the integration of both the etic and emic perspectives in the instrument adaptation model is presented.
Adrian Angold - One of the best experts on this subject based on the ideXlab platform.
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10 year research update review the Epidemiology of child and adolescent Psychiatric disorders ii developmental Epidemiology
Journal of the American Academy of Child and Adolescent Psychiatry, 2006Co-Authors: Jane E Costello, Debra L Foley, Adrian AngoldAbstract:ABSTRACT Objective: To describe the growth of developmental Epidemiology in the past decade and to illustrate it with examples of recent studies. Method: A review of publications on developmental Epidemiology in the past 10 years and a discussion of some key examples. Results: The authors describe how the interaction between developmental psychopathology and Psychiatric Epidemiology has produced developmental Epidemiology, the study of patterns of distribution of Psychiatric disorders in time as well as in space. They give two examples of the kinds of questions that developmental Epidemiology can help to answer: (1) Is the prevalence of autism increasing? Does the use of vaccines explain the increase? (2) Is there an epidemic of child and adolescent depression? Finally, they describe two areas of science that are beginning to inform developmental Epidemiology: molecular genetics and the use of biological measures of stress. Conclusions: While child and adolescent Psychiatric Epidemiology continues, as described in the first of these reviews, to address questions of prevalence and burden, it has also expanded into new areas of research in the past decade. In the next decade, longitudinal epidemiological data sets with their rich descriptive data on psychopathology and environmental risk over time and the potential to add biological measures will provide valuable resources for research into gene-environment correlations and interactions.
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10 year research update review the Epidemiology of child and adolescent Psychiatric disorders i methods and public health burden
Journal of the American Academy of Child and Adolescent Psychiatry, 2005Co-Authors: Jane E Costello, Helen L. Egger, Adrian AngoldAbstract:ABSTRACT Objective To review recent progress in child and adolescent Psychiatric Epidemiology in the area of prevalence and burden. Method The literature published in the past decade was reviewed under two headings: methods and findings. Results Methods for assessing the prevalence and community burden of child and adolescent Psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent Psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease. Conclusions There is mounting evidence that many, if not most, lifetime Psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.
Kristine Yaffe - One of the best experts on this subject based on the ideXlab platform.
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chronicity of posttraumatic stress disorder and risk of disability in older persons
JAMA Psychiatry, 2014Co-Authors: Amy L Byers, Kenneth E Covinsky, Thomas C Neylan, Kristine YaffeAbstract:Importance Little is known about the association between posttraumatic stress disorder (PTSD) and disability into later life. Most studies of late-life Psychiatric disorders and function have focused on depression and generalized anxiety disorder. Objectives To determine the association between PTSD and disability among older adults and investigate if association differs by chronicity of PTSD. Design, Setting, and Participants In total, 3287 participants 55 years and older (mean [SD] age, 66.0 [8.7] years, 60.1% women) involved in the Collaborative Psychiatric Epidemiology Surveys (2001-2003), including 3 aggregated, nationally representative studies (National Comorbidity Survey Replication, National Survey of American Life, and National Latino and Asian American Study). Analyses used weights and complex design-corrected statistical tests to infer generalizability to the US population. Main Outcomes and Measures Disability defined by 5 domains (out of role, self-care, mobility, cognition, and social) using the World Health Organization Disability Assessment Schedule. Results Of the 3.7% older adults who had a history of PTSD defined by DSM-IV criteria, 1.8% had persistent PTSD into later life (age of onset P Conclusions and Relevance Disability in older Americans is strongly associated with PTSD, particularly PTSD that persists into later life. These findings suggest that monitoring and treatment of PTSD are important over the long term.
Jane E Costello - One of the best experts on this subject based on the ideXlab platform.
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10 year research update review the Epidemiology of child and adolescent Psychiatric disorders ii developmental Epidemiology
Journal of the American Academy of Child and Adolescent Psychiatry, 2006Co-Authors: Jane E Costello, Debra L Foley, Adrian AngoldAbstract:ABSTRACT Objective: To describe the growth of developmental Epidemiology in the past decade and to illustrate it with examples of recent studies. Method: A review of publications on developmental Epidemiology in the past 10 years and a discussion of some key examples. Results: The authors describe how the interaction between developmental psychopathology and Psychiatric Epidemiology has produced developmental Epidemiology, the study of patterns of distribution of Psychiatric disorders in time as well as in space. They give two examples of the kinds of questions that developmental Epidemiology can help to answer: (1) Is the prevalence of autism increasing? Does the use of vaccines explain the increase? (2) Is there an epidemic of child and adolescent depression? Finally, they describe two areas of science that are beginning to inform developmental Epidemiology: molecular genetics and the use of biological measures of stress. Conclusions: While child and adolescent Psychiatric Epidemiology continues, as described in the first of these reviews, to address questions of prevalence and burden, it has also expanded into new areas of research in the past decade. In the next decade, longitudinal epidemiological data sets with their rich descriptive data on psychopathology and environmental risk over time and the potential to add biological measures will provide valuable resources for research into gene-environment correlations and interactions.
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10 year research update review the Epidemiology of child and adolescent Psychiatric disorders i methods and public health burden
Journal of the American Academy of Child and Adolescent Psychiatry, 2005Co-Authors: Jane E Costello, Helen L. Egger, Adrian AngoldAbstract:ABSTRACT Objective To review recent progress in child and adolescent Psychiatric Epidemiology in the area of prevalence and burden. Method The literature published in the past decade was reviewed under two headings: methods and findings. Results Methods for assessing the prevalence and community burden of child and adolescent Psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent Psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease. Conclusions There is mounting evidence that many, if not most, lifetime Psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.
