Diagnostic Categories, American Ethnic minorities Culture, and Diversity - Research Paper Example

Diagnostic Categories, American Ethnic minorities’ Culture and Diversity Grade (Feb.7th, Diagnostic Categories, American Ethnic minorities’ Culture and Diversity 1. Do the individuals of the various ethnic groups actually have the diagnosis/diagnoses they are diagnosed with – as stated in the background information? Check at least three different ethnic or cultural groups to understand and determine a pattern of under-diagnosing or over-diagnosing. Discuss your findings. The diagnosis/diagnoses of the American ethnic minorities have shown that different minority groups are prone to different psychological and mental disorders, based on their cultural contexts (Jenkins, 1997). Nevertheless, while some studies have actually shown that the difference exists in the mental and psychological disorders suffered by different ethnic American minority groups, there is still prejudice and bias that has seen some generalization, misdiagnosis and mistreatment of the ethnic minorities. This further complicates the actual understanding of the influence of ethnicity and culture, on the mental and psychological health status of the American minorities (Alarcon, 2009). According to two studies undertaken between two groups, the white Americans and the Russian Americans and funded by the National Institute of Mental Health, culture is an important aspect that modulates the emotional and cognitive aspects of individuals (Nauert, 2010). In the first study comprising of a sample of 83 Russian American students and 85 White American students, the results indicated that the Russians were more dysthymic , exhibiting the characteristics of low-grade depression, whenever they were required to reflect on the dark past experiences (Nauert, 2010). However, the second study comprised of 86 white American students and 76 Russian American students, this time, the study seeking to assess the level of ability to distance from the effects of past negative experiences, and thus assess the level of distress after the negative experience reflection exercise. Contrary to the first study, the results of the second study indicated that the “Russian Americans showed less distress after recalling the experience” (Nauert, 2010). Further, the results indicated that the Russians were easy to spontaneously distance themselves from the distress caused by the previous negative experiences, while the white Americans were more immersed into the depressing experience. Therefore, the disparity in the results shown by the results of the two studies serves to indicate a likelihood of either over-diagnosis in the first study or under-diagnosis in the second study. This is because; the results fail to tally the results, with the first study showing the Russian Americans as more depressed by past negative experiences, while the second study shows the white Americans as the more depressed by past negative experiences (Nauert, 2010). Another study was undertaken to compare the psychiatric patterns exhibited by three American minority ethnic groups, namely the European American, Latino and African American, in Robert Wood Johnson Medical School (Minsky, et al., 2003). The methodology applied entailed the analysis of a large behavioral data that comprised of clinical diagnosis records, administrative data records and self-reported symptoms records. The results of the study indicated that African Americans were observed to display frequent schizophrenic disorders spectrum, than the Latinos and the Euro-Americans (Minsky, et al., 2003). On the other hand, the results indicated that the Latinos displayed a high frequency of disproportionately high levels of major depression, than both the Euro-Americans and the African Americans (Minsky, et al., 2003). However, the fundamental aspect of this study is that; while the Latinos were diagnosed with high frequency of major depression, the health data analysis indicated that the Latinos had self-reported significantly higher levels of psychotic symptoms, including schizophrenia (Minsky, et al., 2003). These results further introduced a significant disparity between the clinical diagnosis and the self-reported symptoms results, an indication that there are still chances that there was either an error of over-diagnosis in relation to the Latinos major depression disorder, while the self-reported records indicated the Latinos as more prone to Psychotic symptoms, as opposed to major depression (Minsky, et al., 2003). The finding of the above three studies, in relation to the four American ethnic minority groups namely the African Americans, Latinos, European Americans and the Russian Americans, indicate that individuals of some minority groups actually do have the diagnosis/diagnoses they are diagnosed with, as found in the background information, with the African Americans found to be prone to schizophrenic disorders spectrum, while the Russian Americans were observed to be prone to the dysthymic spectrum (Nauert, 2010). Nevertheless, the study also indicated that some of the findings were simply either over diagnosed or under diagnosed, with a classic example of over diagnosis being that of the Latinos, whose different sources of data indicated a disparity with the actual results of the findings. The self-reported symptoms data indicated that the Latinos were more prone to psychotic symptoms, while the clinical diagnosis data indicated a disproportionately high level of major depression (Minsky, et al., 2003). The conclusion drawn from these studies in relation to the four American minority ethnic groups serves to indicate that; while some degree of accuracy is present in the cultural association of ethnic minority groups with certain mental and psychological disorders, there are still substantial levels of inaccuracy, which results in relating the minority groups with disorders at levels that are inaccurate. 2. What are the possible reasons for why the researchers obtained the results that they did and what are the possible implications of such findings? The possible reasons for researchers obtaining results that are a clear indication of either over diagnosis or under diagnosis are diverse, and are dependent on the nature of the study undertaken and the individual researchers involved in the study, in relation to how they uphold research ethics or the extent to which they are influenced by bias and stereotypes. Nevertheless, the possible causes of the misdiagnosis observed from the above studies may include: Self-selection bias The studies considered to arrive at the findings entailed the selection of samples to be used as the representative of the whole population of the minority ethnic group’s diagnosis, and there are higher chances that self-selection bias was involved, where the researchers selected the samples that would favor their outcome (Jenkins, 1997). Self-selection bias is detrimental to any credible research process, considering that the researcher selects the samples to use in the study in a way that will favor the predetermined or the desired outcome of the study, thus avoiding selecting a sample that is not fully representative of the general population of the ethnic minority group that is under study. The consequence of this bias is that; the findings of the study will reflect the wishes of the researcher, as opposed to presenting the actual results that a fully-representative sample of the population would have given (Alarcon, 2009). Since the predetermined bias by the researchers would either to portray a certain minority group as displaying a certain mental or psychological disorder, the researcher ends-up either associating an under diagnosed or over diagnosed characteristic with a certain minority group. Culturally determined expression of symptoms Culturally determined expression of symptoms is yet another cause of under diagnosis or over diagnosis of symptoms, for the particular American ethnic minority groups from the above studies. This is because; the researchers could have been wholesomely engrossed with looking for the already cultural symptoms associated with a particular minority group, at the expense of assessing the actual symptoms reflected by the individuals (Alarcon, 2009). For example, in the case of the Latinos being associated and diagnosed with major depression, while the self-reported symptoms data indicated that they had a high prevalence of psychotic symptoms, the clinical staff undertaking the diagnosis would have been influenced by the culturally determined expression of symptoms for the Latino as major depression (Minsky, et al., 2003). This ended up replicating the diagnosis as such, while the actual symptoms are entirely different. The consequence of such bias is that; the results of the study becomes misleading, considering that they portray and associate a certain minority group with a particular mental or psychological disorder, which in the real sense may not be the cultural norm of the ethnic minority group (Alarcon, 2009). Inaccurate application of DSM diagnostic criteria The standard common language and criteria applied by for classifying mental disorders require accuracy, so that the final determination of a study or diagnosis can reflect the true representational characteristics of the participants in the study of a diagnosis (Jenkins, 1997). However, there are certain cases where the researchers or the health officers involved in diagnosing the disorders would apply the wrong DSM diagnostic criteria, which then results to a misdiagnosis of the symptoms of the individuals under study, eventually resulting to findings that are misleading. The major limitation associated with the DSM diagnostic criteria system is that; it is not a holistically scientific principle-based criteria, while at the same time it is prone to subjectivism (Alarcon, 2009). Consequently, on the event that the researcher or the clinicians diagnosing the minority groups end-up applying the wrong DSM diagnostic criteria, the final results will also be wrong and misleading. Clinicians lack of cultural competence While the diagnosis may be undertaken carefully and the correct DSM diagnostic criteria applied in the diagnosis of a minority group mental disorder assessment, the fact that the clinician may not be well acquainted with the cultures of the minority group may result to a misdiagnosis, through the clinician over diagnosing or under-diagnosing certain symptoms portrayed by the members of the minority group (Alarcon, 2009). The consequence of such misdiagnosis is that; the clinician may associate a minority group with a mental disorder that is rarely their characteristic, or alternatively underestimate the symptoms portrayed, and thus end up failing to accurately associate the disorder with the particular minority group. Such failures are the recipes for poor diagnostic results, which eventually fail to tally with the self-reported symptoms of the minority group, as was demonstrated in the Latino minority group diagnosis results, which differed from the actual self-reported symptoms. In this case, the clinicians associated the Latinos with major depression, while self-reported symptoms were psychotic (Minsky, et al., 2003). References Alarcon, R. (2009). “Culture, cultural factors and psychiatric diagnosis: review and projections.” World Psychiatry 8(3): 131–139. Jenkins, J. H. (1997). “Subjective experience of persistent schizophrenia and depression among US Latinos and Euro-Americans” The British Journal of Psychiatry,171:20-25. Minsky S., Vega W., Miskimen T., Gara M., & Escobar J. (2003). “Diagnostic patterns in Latino, African American, and European American psychiatric patients.” Archives of General Psychiatry, 60(6):637-44. Nauert, R. (2010). Russians Complain, Americans Become Depressed. Psych Central. Retrieved on February 7, 2014, from http://psychcentral.com/news/2010/07/14/russians-complain-americans-become-depressed/15575.html Read More