I don’t know why I can’t just calm down: - PowerPoint Presentation

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I don’t know why I can’t just calm down:

Latina Adolescents Struggling with Anxiety Disorders

Nancy Solberg

Majority of individuals from Latin American countries prefer to self-identify by their family’s country of origin

Gender-neutral, non-binary

Emphasizes indigenous cultures and languages (Saldana-Portillo, 2017; DeGuzman, 2017; Image by Wes Bausmith)

Latinxs

in the United States

Fastest growing minority ethnic group in the U.S.17% of U.S. population is LatinxBy 2020, 1 in 5 adolescents will be LatinxBy 2030, the Latinx adolescent population will have a 60% increaseWhile the population will continue to grow nationwide, recent growth spikes in non-historically immigrant-receiving urban and rural communities mean communities in the Southeast are facing larger numbers for the first time

(Coleman-

Minahan

, 2016;

Potochnick

et al., 2012;

Benuto

, 2017)

Projected Latinx population of North Carolina in 2035: 1.6 million

59% of North Carolina’s Latinx are U.S.-born

77% of North Carolina’s Latinx speak a language other than English at home

Most common countries of origin for North Carolinian Latinx: Mexico (57%), Puerto Rico (10%), El Salvador (6%), Honduras (5%), Guatemala (3%)

Durham County’s Latinx population in 2017:

approximately 41,000 = 30%

7,000 Latinx individuals between ages of 10 and 19

(U.S. Census Bureau, 2017; Image from Latinos in/

en

Durham)

Adverse Childhood Experiences (ACEs)

Can include parental domestic violence, substance abuse, mental illness, child abuse and/or neglect, criminal justice involvement, poverty, homelessness, and parental death.

Children exposed to ACEs are more likely to experience physical, mental, social, and behavioral problems as adults than those not exposed to ACEs78% of Latino children have suffered at least 1 ACE28% of Latino children have suffered 4 or more ACEs(Felitti

et al., 1998; Ramirez, 2017)

Anxiety Disorders Among Children & Adolescents

Almost 25% of adolescents meet diagnostic criteria for an anxiety disorder

Earliest mean age of onset (6 years old)Younger children more likely to suffer from specific phobias and separation anxietyAdolescents more likely to suffer from panic disorder, agoraphobia, social anxiety, and generalized anxiety disorderAnxiety disorders place children at greater risk for developing depression and substance abuse disorder

(

Merikangas

et al., 2010; Knapp et al., 2015; William T. Grant Foundation, 2015)

Anxiety disorders are far more common for

female adolescents than male adolescents

(Creswell & Waite, 2016)

(

Nepon

et al., 2010; Merikangas et al., 2010; Perez-Rodriguez et al., 2014)

This should be of special concern since Latina adolescents are already the adolescent group with the highest rate of suicide attempts

As of 2015, 15% of Latina adolescents in the U.S. have attempted suicide and 26% of Latina adolescents in the U.S. have considered suicide

Barriers to Accessing Mental Health Care

Lack of insurance or adequate insurance

Lack of awareness about mental health problems and services availableLack of culturally competent mental health professionalsCultural stigma associated with mental illnessLanguage and shortage of bilingual mental health professionalsProblems identifying psychiatric symptoms when chief complaint is somaticDocumentation Geographical access and transportation

Recommendations

Screen for anxiety using culturally and linguistically appropriate tools

Learn that anxiety can reported to health care providers in different ways depending on the culture of the individualExample: Many Latinas complain of somatic symptoms, feelings of tiredness, worrying too much, and use idioms of distress like “ataque de nervios” and “susto”

Work from a mindset of cultural humility and curiosity

Know where to find services in Spanish

 don’t expect families to be able to find those services themselves

Be aware of the unique barriers this population commonly faces and how you can help them overcome those barriers

Advocate for more bilingual services and more bilingual professionals

(Arredondo et al., 2014)

References

Arredondo, P., Gallardo-Cooper, M., Delgado-Romero, E. A., & Zapata, A. L. (2014).

Culturally responsive counseling with Latinas/os. American Counseling Association. Retrieved from https://ebookcentral-proquest-com.libproxy.lib.unc.edu/lib/unc/detail.action?docID=1889225Benuto, L. T. (Ed.).(2017). Toolkit for Counseling Spanish-Speaking Clients. Springer International Publishing. doi: 10.1007/978-3-319-64880-4

Coleman-

Minahan

, K. (2016). The socio-political context of migration and reproductive health disparities: The case of early sexual initiation among Mexican-origin immigrant young women.

Social Science & Medicine, 180

, 85-93.

doi

: 10.1016/j.socscimed.2017.03.011

Creswell, C. & Waite, P. (2016). Recent developments in the treatment of anxiety disorders in children and adolescents.

Evidence-Based Mental Health, 19

(3), 65-69.

doi

: 10.1136/eb-2016-102353

DeGuzman

, M. (2017). Latinx:

Estamos

aqui

, or being “Latinx” at UNC-Chapel Hill.

Cultural Dynamics, 29

(3), 214-230.

doi

: 10.1177/0921374017727852

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, V. J.,

Anda

, R. F.,

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, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study.

American Journal of Preventive Medicine, 14

(4), 245-257.

Knapp, A. A., Blumenthal, H.,

Mischel

, E. R.,

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, C. L., &

Leen-Feldner

, E. W. (2015). Anxiety sensitivity and its factors in relation to generalized anxiety disorder among adolescents.

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Merikangas

, K. R., He, J. P., Burstein, M., Swanson, S. A.,

Avenevoli

, S., Cui, L.,

Benjet

, C.,

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, K., &

Swendsen

, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A).

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(10), 980-989.

doi

: 10.1016/j.jaac.2010.05.017

Nepon

, J., Belike, S. L., Bolton, J., &

Sareen

, J. (2010). The relationship between anxiety disorders and suicide attempts: Findings from the national epidemiologic survey on alcohol and related conditions.

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(9), 791-798.

doi

: 10.1002/da.20674

Perez-Rodriguez, M

M

., Baca-Garcia, E.,

O

quendo

, M. A., Wang, S., Wall, M. M., Liu, S. M., & Blanco, C. (2014). Relationship between acculturation, discrimination, and suicidal ideation and attempts among US Hispanics in the national epidemiological survey of alcohol and related conditions.

Journal of Clinical Psychiatry, 75

(4), 399-407.

doi

: 10.4088/JCP.13m08548

Potochnick

, S.,

Perreira

, K. M., &

Fuligni

, A. (2012). Fitting in: The roles of social acceptance and discrimination in shaping the daily psychological well-being of Latino youth.

Social Science Quarterly, 93

, 173-190.

doi

: 10.1111/j.1540-6237.2011.00830.x

Ramirez, A. (2017). Latino childhood development research: Childhood trauma.

Salud

America!

Retrieved from:

https://salud-america.org

Saldana-Portillo, M. J. (2017). Critical Latinx

indigeneities

: A paradigm drift.

Latino Studies, 15

(2), 138-155.

doi

:

10.1057/s41276-017-0059-x

U.S. Census Bureau (2017).

Hispanic origin

. Retrieved from

https://

www.census.gov/topics/population/hispanic-origin/about.html

William T. Grant Foundation. (2015).

Disparities in child and adolescent mental health and mental health services in the U.S.

Washington, DC:

Alegria

, M. & Green, J. G.