Diversity--Kohlenberg Flashcards
Which gender is depression more common in?
women
What is the #1 most disabling disorder worldwide?
depression
T/F Most suicides are in high income families.
False.
86% of whom are in low income and middle income countries, more than half are between 15-44 years old.
What’s the important study in Uganda?
interpersonal therapy was so effective than 6 mo later 94% no longer had major depression
In pakistan, basic CBT showed which results?
helped moms
helped the health of babies
Which ethnic group showed the highest suicide rates in younger years? Next highest?
Native American
Then white
What is happening to the suicide rates in boys age 10-14 in the African American population?
increasing
What’s the deal with health disparity in African American population?
under represented in outpatient
over represented in inpatient
somatization: 15% (higher than caucasian)
Are there many African American psychiatrists?
only 2% of psychiatrists
How is metabolism of psych meds different in the AA population?
may metabolize those meds more slowly
T/F One study found that physicians were 23% more verbally dominant and engaged in 33% less patient‐centered communication with African American patients than with white patients. (11)
Sadly, true.
What are asian americans more likely to present with–mental health or physical symptoms?
more likely to present with somatic complaints
Which age ranges for Asian American women are highest?
suicide rates highest in elderly & young women
T/F Asian Americans have higher rates of substance abuse disorders.
False. Lower
What are the rates of sadness, substance abuse, and suicide in latino youth ?
more sadness
more suicide
less alcohol & illicit drug use
T/F If you are born in the US, you are more likely to seek help medically.
True.
What are strength & protective factors for Native Americans ?
strong identification w/ culture family connection w/ the past traditional health practices adaptability wisdom of elders
What are the challenges to health & well being for Native Americans?
alcohol misuse
enduring spirit
long memories
trauma is communal
What is ethnopsychopharmacology?
Cultural and ethnic influences on responses to medications (genetic and cultural).
Genetic differences in drug metabolism and cultural practices that impact diet, adherence, placebo effects.
33% of African Americans and 37% of Asians are slow metabolizers of tricyclic antidepressants and ssri’s.
What proportion of US women experience intimate partner violence?
1/4
domestic violence leading cause of injury to American Women
What is the highest cause of death for pregnant & recently pregnant women?
homicide by intimate partner
What % of men experience intimate partner violence in their lives?
28.5% lifetime prevalence
What proportion of high school students are physically or sexually abused by a partner?
1/5 high school students
ACE leads to increased risk for suicide. HOw much of an increased risk?
80% increase in attempted suicide
How is physical abuse defined?
Pushing, shoving, slapping, punching, kicking, choking, assault with a weapon, holding, tying down, restraining, leaving in a dangerous place, refusing to help when sick or injured.
How is emotional abuse defined?
Threats of harm, falsely accusing, blaming for everything, extreme jealousy and possessiveness, deprivation, intimidation, humiliation, name calling, constantly criticizing, insulting ,ignoring, dismissal, ridiculing needs, lying to, breaking promises, behaving recklessly in order to frighten and intimidate, using money as a control method…
How is sexual abuse defined?
Trying to force sexual performance against the patient’s will or when not fully conscious or when afraid to say no.
Physically hurting the patient during sex or assaulting the patient’s genitals.
Use of threats
How do we screen for domestic violence?
screening asymptomatic female patients may provide benefits
ACA: includes coverage for screening
What is a good screening question to ask ?
All couples argue…when you and your partner argue, is physical violence involved.
