Personality and psychopathology: In defense of a practical path toward integrating psychometric and biological approaches to advance a comprehensive model.

Personality and psychopathology each reflect patterns of internal experience and outward behavior that differ between people and affect functioning. Drawing strict distinctions between the two concepts is not only difficult, but it may prove unnecessary for advancing an integrated model of psychological experiences associated with mental illness. We argue that developing such a model will be critical for improving treatment outcomes, and we discuss a practical path forward. Proponents of psychometric approaches to developing models of psychological experience focus on observable phenotypes and utilize statistical methods to describe patterns of covariation among a broad range of symptoms and dispositions. Advocates of biologically based approaches emphasize neuroscientific tools for identifying abnormalities in brain function that give rise to an individual's experience. There is substantial evidence that measures of personality and measures of symptoms capture nonoverlapping, clinically important information for understanding how and for whom treatments for mental illness work. In this article, we highlight the importance of combining psychometric and neurobiological approaches in order to understand which features of an individual those measures reflect, which aspects of neurobiology generate and maintain those features, how they relate to each other, and critically, how best to alter them to reduce distress and dysfunction.

Geographic Disparities in the Relation between English Proficiency and Health Insurance Status among Older Latino and Asian Immigrants.

This study examines whether English proficiency and geographic context explain health insurance status among older Latino and Asian immigrants in the U.S. Drawn from the 2010-2012 ACS PUMS, 57,936 Latino and 47,742 Asian immigrants aged 65 and older were selected. Logistic regression analysis was conducted for the U.S. as a whole and separately by geographic region. In the entire U.S., having limited English proficiency (LEP) and being proficient in English (EP) increased odds of being uninsured among Latino immigrants, whereas LEP and EP decreased odds of being uninsured among Asian immigrants. In the stratified analyses for geographic regions, there were significant ethnic differences in the directionality of the relation between English proficiency and uninsured status. Regional institutions should take care to expand access to information on health care and insurance coverage to racial/ethnic minorities, taking into account the characteristics of these groups at the local level.

Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.

PURPOSE: The main purpose of this paper is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US. METHODS: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES; 2001-2003), adults with any past year psychiatric disorder diagnosis (n = 3211) from diverse racial/ethnic backgrounds were selected for analyses. Using weighted data, descriptive analyses and logistic regression analyses were conducted. RESULTS: Two-thirds of the total sample had unmet mental health care need, which differed significantly by race/ethnicity (p < .001). Logistic regression analyses show regional variation of the effect of race/ethnicity in unmet need: after adjusting for covariates, Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast. CONCLUSIONS: Findings suggest that geographic region plays an important role in the sufficient use of mental health services among racial/ethnic minorities. Further research should elucidate reasons for geographic disparities in mental health care among racial/ethnic minority adults to reduce disparities.

Racial/ethnic variations in the relation between body mass index and cognitive function among older adults.

OBJECTIVES: The present study examines racial/ethnic variations in the relation between body mass index (BMI) and cognitive function among older adults. DESIGN: Cross-sectional study of secondary data. SETTING: Data were obtained from the 2010 Health and Retirement Study. PARTICIPANTS: Racial/ethnic groups analyzed were black (n = 546), Hispanic (n = 110), and non-Hispanic white (n = 4,104). MEASUREMENTS: BMI was calculated based on self-reported height and weight. Cognitive function was measured based on Telephone Interview for Cognitive Status-Health and Retirement Study version scores. RESULTS: Significant main effects were found for both BMI and race/ethnicity, indicating that cognitive function varies significantly by both. The BMI × race/ethnicity interaction was also found to be significant. The interaction revealed that among the white sample cognitive function scores tended to increase as BMI increased whereas the opposite relation was observed in the Hispanic sample. The black sample displayed a similar pattern as the white sample, although a decrease was observed in cognitive function scores once BMI reached obesity. CONCLUSION: The results suggest that the relation between BMI and cognitive function does vary by race ethnicity. Therefore, it can be concluded that high or low BMI may vary as a risk or protective factor for cognitive dysfunction among older adults by race/ethnicity. Implications for research and clinical work are discussed.

Race/ethnicity and measurement equivalence of the Everyday Discrimination Scale.

The present study examines the effect of race/ethnicity on measurement equivalence of the Everyday Discrimination Scale (EDS; Williams, Yu, Jackson, & Anderson, 1997). Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES; Alegría, Jackson, Kessler, & Takeuchi, 2008), adults aged 18 and older from four racial/ethnic groups were selected for analyses: 884 non-Hispanic Whites, 4,950 Blacks, 2,733 Hispanics/Latinos, and 2,089 Asians. Multiple-group confirmatory factor analyses were conducted. After adjusting for age and gender, the underlying construct of the EDS was invariant across four racial/ethnic groups, with Item 7 ("People act as if they're better than you are") associated with lower intercepts for the Hispanic/Latino and Asian groups relative to the non-Hispanic White and Black groups. In terms of latent factor differences, Blacks tended to score higher on the latent construct compared to other racial/ethnic groups, whereas Asians tended to score lower on the latent construct compared to Whites and Hispanics/Latinos. Findings suggest that although the EDS in general assesses the underlying construct of perceived discrimination equivalently across diverse racial/ethnic groups, caution is needed when Item 7 is used among Hispanics/Latinos or Asians. Implications are discussed in cultural and methodological contexts.

Geographic and racial-ethnic differences in satisfaction with and perceived benefits of mental health services.

OBJECTIVE: This study examined whether racial-ethnic differences in satisfaction with and perceived benefits from mental health services vary by geographic region among U.S. adults. METHODS: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), selected samples consisted of 2,160 adults age 18 and older from diverse racial-ethnic groups (Asian, black, Hispanic/Latino, and white) who had used mental health services in the past 12 months. Generalized linear model analysis was conducted for the United States as a whole and separately by geographic region (Northeast, South, Midwest, and West) after adjustment for covariates. RESULTS: In the national sample, no significant main effects of race-ethnicity and geographic region were found in either satisfaction with or perceived benefits from mental health services. In the stratified analyses for geographic regions, however, significant racial-ethnic differences were observed in the West; blacks in the West were significantly more likely to report higher satisfaction and perceived benefits, whereas Hispanics/Latinos in the West were significantly less likely to do so. CONCLUSIONS: The findings suggest that there are regional variations of racial-ethnic differences in satisfaction with and perceived benefits from mental health services among U.S. adults and that addressing needs of Hispanics/Latinos in the West may help reduce racial-ethnic disparities in mental health care. Clinical and policy implications are discussed.