Causal beliefs and treatment preferences for the symptoms of depression among chronically ill African Americans, Latino, and White patients

The focus of the research study is to explore chronically ill African American, Latino, and White patients' causal attributions of symptoms of depression and factors that predict depression care treatment preferences among these groups. Research has demonstrated that perception of illness impacts what treatments a person will deem appropriate for their mental health problems and from whom they will seek treatment. Research also indicates that certain ethnic groups are more likely to seek treatment for their symptoms of depression in the primary care setting. Yet, it is unclear how they actually perceive their symptoms and what best predicts the treatments that they are likely to consider acceptable. A convenient sample of 109 HIV+ adults, 79 diabetic adults, and 3 adults with both conditions were recruited for this study. Participants had to be receiving services for either HIV, diabetes, or both conditions in one of the three central Austin facilities and be a representative from one of three racial/ethnic groups: African Americans, Latino, and White. Differences were found across ethnicity with regard to causal beliefs and treatment preferences for the symptoms of depression both among the HIV and the diabetic subgroups. Latinos in both groups were more likely than Whites to prefer counseling or a single form of treatment over combined treatment methods. Diabetic Latinos were more likely to prefer counseling for symptoms of depression. HIV seropositive individuals who reported the least number of symptoms of physical illness were more likely to attribute their symptoms of depression to stressful life events, whereas those who reported the greatest number of symptoms of physical illness were more likely to attribute their symptoms of depression to their medical illness. Additionally among the HIV subgroup, individuals who reported high stress tended to predict the preferences for treatment provided by a psychiatrist/psychologist and Whites scored highest on this factor. Finally, differences in depression scores across race/ethnicity were also revealed. The utility of assessing a patient's understanding of symptoms of depression in order to determine how personal illness models impact treatment preferences and knowledge of patient's causal attributions can aid medical social workers and physicians in collaborative management of chronic illness and depression are discussed.