Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

doi:10.1016/j.xjmad.2023.100030

. 2023 Sep 29:4:100030.

doi: 10.1016/j.xjmad.2023.100030. eCollection 2023 Dec.

Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

Darius B Dawson^{1

2

3}, Christie G-J Tsao¹, Patricia Chen^{1

2

3}, Traber D Giardina^{1

3}, Terri L Fletcher^{1

2

4}

Affiliations

¹ Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 156), 2002 Holcombe Blvd., Houston, TX 77030, USA.
² South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey VA Medical Center (a virtual center), Houston, TX, USA.
³ Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 USA.
⁴ Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

PMID: 40656970
PMCID: PMC12244107
DOI: 10.1016/j.xjmad.2023.100030

Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

Darius B Dawson et al. J Mood Anxiety Disord. 2023.

. 2023 Sep 29:4:100030.

doi: 10.1016/j.xjmad.2023.100030. eCollection 2023 Dec.

Authors

Darius B Dawson^{1

2

3}, Christie G-J Tsao¹, Patricia Chen^{1

2

3}, Traber D Giardina^{1

3}, Terri L Fletcher^{1

2

4}

Affiliations

¹ Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 156), 2002 Holcombe Blvd., Houston, TX 77030, USA.
² South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey VA Medical Center (a virtual center), Houston, TX, USA.
³ Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 USA.
⁴ Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

PMID: 40656970
PMCID: PMC12244107
DOI: 10.1016/j.xjmad.2023.100030

Abstract

Objectives: We examined providers' perspectives about how culture affects diagnosing and recognizing anxiety.

Methods: We interviewed providers about diagnosing anxiety ("How do you think culture impacts expression and diagnosis of anxiety?") and used inductive analysis, with open coding, to allow themes to emerge organically.

Results: We identified three themes: (1) Impartiality toward Culture: downplaying culture in recognizing or diagnosing anxiety and not acknowledging necessary cultural diagnostic considerations; (2) Acknowledgment of Cultural Impact: detailed variations across different cultural communities in how patients present with and describe anxiety, with differing levels of stigma associated with expressing and treating anxiety; (3) Culturally Integrated Practice: implement culturally informed diagnosis and treatment, with training and self-directed processing on culture and bias.

Conclusions: While most providers acknowledge that culture impacts accurate diagnosis of anxiety, they vary in how they integrate cultural information. It is important to deliver culturally informed care.

Keywords: Anxiety; Culture; Diagnosis; Qualitative; Veterans.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Darius B. Dawson reports a relationship with Anxiety and Depression Association of America that includes: travel reimbursement.

References

1. Anxiety and Depression Association of America. Anxiety Disorders - Facts & Statistics. Washington, DC: ADAA; 2023. 〈https://adaa.org/understanding-anxiety/facts-statistics〉.
1. Bandelow B., Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialog Clin Neurosci. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow. - DOI - PMC - PubMed
1. Chand S.P., Mawaha R. Anxiety. StatPearls; 2022.
1. La Roche M.J., Fuentes M.A., Hinton D. A cultural examination of the DSM-5: Research and clinical implications for cultural minorities. Prof Psychol Res Pr. 2015;46(3):183–189. doi: 10.1037/a0039278. - DOI
1. Torres J.M., Lawlor J., Colvin J.D., Sills M.R., Bettenhausen J.L., Davidson A., Cutler G.J., Hall M., Gottlieb L.M. ICD Social Codes: an underutilized resource for tracking social needs. Med Care. 2017;55(9):810–816. doi: 10.1097/MLR.0000000000000764. - DOI - PubMed

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[1] Anxiety and Depression Association of America. Anxiety Disorders - Facts & Statistics. Washington, DC: ADAA; 2023. 〈https://adaa.org/understanding-anxiety/facts-statistics〉.

[2] Anxiety and Depression Association of America. Anxiety Disorders - Facts & Statistics. Washington, DC: ADAA; 2023. 〈https://adaa.org/understanding-anxiety/facts-statistics〉.

[3] Bandelow B., Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialog Clin Neurosci. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow. - DOI - PMC - PubMed

[4] Bandelow B., Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialog Clin Neurosci. 2015;17(3):327–335. doi: 10.31887/DCNS.2015.17.3/bbandelow. - DOI - PMC - PubMed

[5] Chand S.P., Mawaha R. Anxiety. StatPearls; 2022.

[6] Chand S.P., Mawaha R. Anxiety. StatPearls; 2022.

[7] La Roche M.J., Fuentes M.A., Hinton D. A cultural examination of the DSM-5: Research and clinical implications for cultural minorities. Prof Psychol Res Pr. 2015;46(3):183–189. doi: 10.1037/a0039278. - DOI

[8] La Roche M.J., Fuentes M.A., Hinton D. A cultural examination of the DSM-5: Research and clinical implications for cultural minorities. Prof Psychol Res Pr. 2015;46(3):183–189. doi: 10.1037/a0039278. - DOI

[9] Torres J.M., Lawlor J., Colvin J.D., Sills M.R., Bettenhausen J.L., Davidson A., Cutler G.J., Hall M., Gottlieb L.M. ICD Social Codes: an underutilized resource for tracking social needs. Med Care. 2017;55(9):810–816. doi: 10.1097/MLR.0000000000000764. - DOI - PubMed

[10] Torres J.M., Lawlor J., Colvin J.D., Sills M.R., Bettenhausen J.L., Davidson A., Cutler G.J., Hall M., Gottlieb L.M. ICD Social Codes: an underutilized resource for tracking social needs. Med Care. 2017;55(9):810–816. doi: 10.1097/MLR.0000000000000764. - DOI - PubMed

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Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

Affiliations

Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

Authors

Affiliations

Abstract

Conflict of interest statement

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References

LinkOut - more resources

Full Text Sources