Diversity--Kohlenberg

Question 1

Which gender is depression more common in?

Answer 1

women

Question 2

What is the #1 most disabling disorder worldwide?

Answer 2

depression

Question 3

T/F Most suicides are in high income families.

Answer 3

False.

86% of whom are in low income and middle income countries, more than half are between 15-44 years old.

Question 4

What’s the important study in Uganda?

Answer 4

interpersonal therapy was so effective than 6 mo later 94% no longer had major depression

Question 5

In pakistan, basic CBT showed which results?

Answer 5

helped moms

helped the health of babies

Question 6

Which ethnic group showed the highest suicide rates in younger years? Next highest?

Answer 6

Native American

Then white

Question 7

What is happening to the suicide rates in boys age 10-14 in the African American population?

Answer 7

increasing

Question 8

What’s the deal with health disparity in African American population?

Answer 8

under represented in outpatient
over represented in inpatient
somatization: 15% (higher than caucasian)

Question 9

Are there many African American psychiatrists?

Answer 9

only 2% of psychiatrists

Question 10

How is metabolism of psych meds different in the AA population?

Answer 10

may metabolize those meds more slowly

Question 11

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)

Answer 11

Sadly, true.

Question 12

What are asian americans more likely to present with–mental health or physical symptoms?

Answer 12

more likely to present with somatic complaints

Question 13

Which age ranges for Asian American women are highest?

Answer 13

suicide rates highest in elderly & young women

Question 14

T/F Asian Americans have higher rates of substance abuse disorders.

Answer 14

False. Lower

Question 15

What are the rates of sadness, substance abuse, and suicide in latino youth ?

Answer 15

more sadness
more suicide
less alcohol & illicit drug use

Question 16

T/F If you are born in the US, you are more likely to seek help medically.

Answer 16

True.

Question 17

What are strength & protective factors for Native Americans ?

Answer 17

strong identification w/ culture
family
connection w/ the past
traditional health practices
adaptability
wisdom of elders

Question 18

What are the challenges to health & well being for Native Americans?

Answer 18

alcohol misuse
enduring spirit
long memories
trauma is communal

Question 19

What is ethnopsychopharmacology?

Answer 19

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.

Question 20

What proportion of US women experience intimate partner violence?

Answer 20

1/4

domestic violence leading cause of injury to American Women

Question 21

What is the highest cause of death for pregnant & recently pregnant women?

Answer 21

homicide by intimate partner

Question 22

What % of men experience intimate partner violence in their lives?

Answer 22

28.5% lifetime prevalence

Question 23

What proportion of high school students are physically or sexually abused by a partner?

Answer 23

1/5 high school students

Question 24

ACE leads to increased risk for suicide. HOw much of an increased risk?

Answer 24

80% increase in attempted suicide

Question 25

How is physical abuse defined?

Answer 25

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.

Question 26

How is emotional abuse defined?

Answer 26

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…

Question 27

How is sexual abuse defined?

Answer 27

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

Question 28

How do we screen for domestic violence?

Answer 28

screening asymptomatic female patients may provide benefits

ACA: includes coverage for screening

Question 29

What is a good screening question to ask ?

Answer 29

All couples argue…when you and your partner argue, is physical violence involved.