An Ethnic/Racial Comparison of Causal Beliefs and Treatment Preferences for the Symptoms of Depression Among Patients with Diabetes

Abstract

Purpose The purpose of the study was to explore African American, Latino, and Non-Hispanic White adult patients with type 2 diabetes cultural perceptions of symptoms of depression and factors that predict depression care treatment preferences between these groups. Methods A community sample of African Americans, Latinos, and White diabetic adults receiving services in 1 of 2 central Austin, Texas facilities participated in the study. Each participant was given a survey, which consisted of the following 5 components: (1) illness screener questions, (2) demographic questions, (3) Patient Health Questionnaire, (4) Depression Treatment Questionnaire, and (5) Illness Perception Questionnaire. A binary logistic regression was used to examine the relationship between cultural perceptions of symptoms and the predictor variables. A multinomial logistic regression analyses was used to examine the relationship between treatment and provider preferences for the symptoms of depression and ethnicity. Results The first research question addressed whether there were differences across ethnicity in how symptoms of depression are attributed among patients with diabetes. There were 7 causal beliefs that were associated with differences in cultural endorsements of the causes of depressive symptoms. In addition, culture was associated with treatment preferences but not with provider preferences. Conclusions The utility of assessing a patient’s understanding of symptoms of depression to determine how personal illness models impact treatment preferences and clinical implications of how knowledge of patient’s causal attributions can aid medical and behavioral health providers working in collaborative management of diabetes and depression are discussed.