Family Factors Related to Major Psychiatric Disorders in Latina/o Americans Nationwide

Background: Despite a rapidly growing Latina/o American population, little is known about modifiable factors that could protect Latina/os against major psychiatric disorders. Encountering the mainstream individualism omnipresent in the USA could well impact the family values of Latinas with non-Western traditions, such that other-oriented family responsibilities could sometimes become detrimental. The present study explored psychosocial risk (Negative Interaction) and protective factors (Family Cohesion, Social Support, Religious Involvement, Racial and Ethnic Identity) for major depressive disorder (MDD), general anxiety disorder (GAD), and suicidal ideation (SI) among Latina/os participating in the first national mental health epidemiological survey of Latina Americans.

Method: We conducted three sets of logistic regressions, predicting outcomes for 1,427 Latinas and Latinos, respectively, identified in the National Latino and Asian American Study (NLAAS), the first nationally representative, epidemiological study of Latino and Asian Americans living in the United States. Logistic regression analyses were conducted to investigate odds ratios (ORs) and 95% confidence intervals (CIs) as estimates of the relationship between family factors and three diagnoses in each gender group, controlling for socio-demographics. These analyses followed preplanned steps: Model 1 (Step 1) used known predictors as controls and Model 2 (Step 2) added psychosocial risk and predictive factors beyond the known predictors.

Results: In Latinas’ analyses, psychosocial risk and protective factors produced a significantly better model fit in Model 2 than sociodemographic and acculturation variables known to predict each outcome examined [i.e., Model 1 (x2_mdd change=14.62; df=5; p<.05; x2_gad change=21.41; df=5; p<.01; x2_SI change=18.97; df=5; p<.01)]. Negative Interactions were associated with increased likelihood of GAD (OR=1.5, 95% CI: 1.02,2.22, p<.05) and SI (OR=2.30, 95% CI: 1.489,3.538, p<.0001), whereas Family Cohesion seemed to be protective against GAD (OR=0.8, 95% CI:0.68,0.93, p<.01). No psychosocial factors predicted MDD. In Latino analyses, similar significantly better model fit was also observed between the two steps of logistic models. Negative Interactions occurred as a single significant predictor for MDD among Step-2 psychosocial factors. Every increased level of such interactions added the likelihood of a MDD diagnosis by 94.2%.  Negative Interactions occurred as a single significant predictor for SI among Step 2 psychosocial factors. Every increased level of such interactions added the likelihood of a SI diagnosis by 129.6%, while Discrimination remained to be a significant predictor among all Step 1 independent factors. No psychosocial factors predicted GAD, while none of them appeared to be protective for Latino men’s mental health.

Conclusion: The differential prediction for mental health issues between Latinas and Latinos implies that assessment and intervention for this largest minority population in the United States may need certain sex-specific foci in order to improve mental health disparities among social workers and other mental health providers. Furthermore, differential protective and risk factors for major psychiatric disorders within each gender suggest that certain family dynamic-related components may affect Latinas and Latinos in varied ways given their contextual difference and gender-related challenges that they face in the United States.