The unfolding depressive symptoms, disease self-management, and treatment utilization for Latina adolescents

Indiana University-Purdue University Indianapolis (IUPUI)Latina adolescents are more likely to suffer from depressive symptoms and less likely to receive mental health services for depression than their White peers, and this mental health disparity is poorly understood. The purpose of this dissertation study is to describe how Latina adolescents experience and seek mental health services for their depressive symptoms. The dissertation includes three components. The first is an integrative literature review to determine which cultural stressors are associated with depressive symptoms among Latino/a youth. The results indicate that discrimination, family culture conflict, acculturative and bicultural stress, intragroup rejection, immigration stress, and context of reception are associated with depressive symptoms in this population. The second and third components were based on interviews with 25 Latinas (ages 13-20) who experienced depressive symptoms during adolescence. In the second component, a content analysis was conducted to determine cultural stressors experienced by contemporary Latinas living in a tumultuous sociopolitical climate in the United States. The stressors included (a) pressure to succeed, (b) parental oversight, (c) being treated differently, and (d) fears of deportation. In the third component, grounded theory methods were used to develop a theoretical framework to describe the process by which Latina adolescents self-managed and sought treatment for depressive symptoms. In this framework, participants shared a psychosocial problem labeled Being Overburdened and Becoming Depressed. They responded to this problem through the psychosocial process labeled Getting a Grip on My Depression, which consisted of five phases: 1) hiding my depression, 2) keeping my depression under control, 3) having my depression revealed, 4) skirting treatment for my depression, and 5) deciding to move on from depression. The Latino family, peer groups, and mainstream authorities influenced the participants’ experiences. The process of experiencing, self-managing, and seeking treatment for depressive symptoms for Latina adolescents is both similar to and unique from the processes by which other groups of adolescents experience depressive symptoms. These results will contribute to the development of culturally-sensitive strategies to prevent, identify, and treat depressive symptoms in Latina adolescents

Emerging Adult Women’s Views-of-Self in Intimate Partner Relationships that are Troubled

The purpose of this study is to describe how emerging adult (EA) women describe their views-of-self in troubled relationships. Fourteen EA women (ages 18–25) wrote four stories about their troubled relationships during a guided-writing intervention. Qualitative descriptive methods and content analysis were used to identify common views-of-self. Four views-of-self in troubled relationships and contrasting views-of-self emerged: (1) silent self-vocal self, (2) sacrificing self-prioritized self, (3) caretaking self-boundary-setting self, and (4) insecure self-secure self. Mental health nurses and other clinicians can use these views-of-self pairs to guide their discussions with EA young women who are involved in troubled relationships

Barriers to and Facilitators of Mental Health Treatment Engagement among Latina Adolescents

Latina adolescents are more likely to experience depressive symptoms and less likely to receive mental health treatment than White peers. The purpose of this study is to describe barriers to and facilitators of engagement in depression treatment among Latina adolescents. Twenty-five Latina young women (mean age=16.7 years) with a history of depressive symptoms during adolescence participated in this qualitative descriptive study. Participants were recruited from clinical and community settings and were interviewed about their experiences with depression treatment. Using qualitative content analysis, we identified barriers to and facilitators of engagement in treatment for depression. Barriers included beliefs about depression and its treatments, negative experiences with treatment, and logistical problems. Facilitators included positive treatment outcomes, meaningful connection with a therapist, and family support of depression treatment. Mental health providers should minimize barriers and maximize facilitators to promote mental health treatment use and engagement among Latina adolescents with depressive symptoms

Getting a Grip on My Depression: How Latina Adolescents Experience, Self-Manage, and Seek Treatment for Depressive Symptoms

Latina (female) adolescents are more likely to experience depressive symptoms and less likely to receive mental health services than their non-Latina White peers. We aimed to develop a framework that explains how Latina adolescents experience, self-manage, and seek treatment for depressive symptoms. Latina young women (n = 25, M age = 16.8 years) who experienced depressive symptoms during adolescence were recruited from clinical and community settings and interviewed about experiences with depressive symptoms. The framework was developed using constructivist grounded theory methods. Participants experienced a psychosocial problem that we labeled being overburdened and becoming depressed. They responded to this problem through a five-phase psychosocial process that we labeled Getting a Grip on My Depression. Family members, peer groups, and mainstream authorities were influential in how participants experienced these phases. Future research should further develop this framework in diverse samples of Latino/a youth. Clinicians can use this framework in discussions with Latina adolescents about depressive symptoms

The Influence of Peer Relationships on Latina Adolescents’ Experiences with Depressive Symptoms

Purpose: Previous research has demonstrated that peers may play an integral role in the development of depressive symptoms among Latina adolescents; however, little is known about the function of peers in the ongoing management of depressive symptoms for Latina adolescents. The purpose of this study was to describe how peers influence Latina adolescents' experiences with the onset and ongoing management of depressive symptoms. Design and methods: Qualitative descriptive methods were used in conducting semi-structured interviews with twenty-five young Latinas (ages 13-20) who had a history of depressive symptoms during adolescence. Participants were asked to describe their experiences with depressive symptoms and how they interacted with others in relation to their depressive symptoms. Thematic analysis methods were used to identify common themes in how peers influenced Latina adolescents' experiences with depressive symptoms. Results: Latina adolescents experienced tensions with peers in the development, disclosure, and self-management of depressive symptoms. Peers were: 1) allies and bullies; 2) confidants and betrayers; and 3) up-lifters and downers. Conclusions: Peer relationships can be a source of risk and resiliency for Latina adolescents throughout the process of experiencing depressive symptoms. Practice implications: Interventions preventing or treating depression among Latina adolescents should capitalize on the strengths of peer relationships, while recognizing that peers may also contribute to risk

The Natural Course of Adolescent Depression Treatment in the Primary Care Setting

Introduction: Little is known about how adolescents receive depression follow-up in primary care. The purpose of this study was to describe the rates of symptom assessment and depression treatment over time in a group of adolescents screening positive for moderate or severe depression in the primary care setting. Methods: Retrospective chart reviews were conducted to gather information related to symptom reassessments, antidepressant prescriptions, psychotherapy referrals, and treatment discontinuation. Descriptive statistics were calculated, and a qualitative content analysis was conducted to determine the reasons for treatment discontinuation. Results: Eighty records were reviewed (mean age = 15.3, 73% female, 59% Black). Treatment was initiated for 83% (n = 66) of patients, and 45% (n = 30) of patients discontinued treatment during the review period for a variety of reasons. Discussion: To improve adolescents' adherence to depression treatment, providers should address factors that contribute to treatment discontinuation and use tools to manage depression follow-up care

Cultural Stressors Described by Latina Young Women Living in a Tumultuous Sociopolitical Climate

To describe the types of cultural stressors that Latina young women living in the US experienced from 2016- 2018 with respect to generational status

Cultural stressors experienced by young Latinas with depressive symptoms living in a tumultuous sociopolitical climate in the United States

The purpose of this study is to describe the cultural stressors experienced by Latina young women with depressive symptoms from 2016-2018 in the United States. Twenty-four Latina young women (mean age=16.7 years) participated in this qualitative descriptive study. Content analysis of interviews revealed four cultural stressors: Parental oversight, pressure to succeed, being treated differently, and fears of deportation. Experiences with cultural stressors varied across generational status. Clinicians should provide Latina young women with a safe space for discussing cultural stressors, assess how they are managing their stress, and advocate for policies that will benefit the well-being of Latina young women