ADHD

The Attention Deficit/Hyperactivity Disorder (ADHD) is a

developmental disorder featuring maladaptive levels of inattention,
excessive activity, and impulsiveness. The disorder is often triggered by
genetic and biological abnormalities as well as environmental factors and
is usually prolonged from childhood to adulthood. DSM-IV-TR differentiates
three types of symptoms. The first includes problems of inattention,
second type is hyperactivity and the third is impulsivity (Durand & Barlow,
2010). ADHD is estimated to occur in 3% to 7% of school-age children in
the United States, and an important analysis of prevalence suggests that
the disorder is found in about 5.2% of the child populations across all
regions of the world (Polanczyk, de Lima, Horta, Biederman, & Rodhe,
2007) One of the reasons for this is genetics. Studies shown that more
than one gene is probably responsible for ADHD (Bobb, Castellanos,
Addington, & Rapoport, 2006) Some socio-cultural factors also affects it.
Most of the children diagnosed with ADHD are victims of racial
discrimination and have a poor family background. Because of poverty,
they cannot afford the right medication to improve the condition.
SMOKING
Another cause can be Maternal Smoking, or mothers who are
smoking during pregnancy. White women who are pregnant are more
likely to smoke cigarettes than African-American or Hispanic mothers-tobe, a new government report shows. The study found that pregnant white
women had high rates of cigarette smoking at 21.8% compared with
14.2% among African-American women and 6.5% among Hispanic
women. (Nierenberg, 2012) Furthermore, according to Kahn, Khoury,
Nichols & Lanphear (2003), children with a specific mutation involving the
dopamine system (the DAT1 genotype) were more likely to exhibit the
symptoms of ADHD if their mothers smoked during pregnancy.
FOOD ADDITIVES
Feingold (2011) also presented that Food Additives also had a
substantial impact for the symptoms of ADHD. Artificial food colorings,
preservatives, and other additives may play a role in increasing
hyperactive behavior among young children. Since then, many have tried
to research further to support Feingolds claim but were unsuccessful, or
have shown only a small benefit in learning and behavioral problems in
children with ADHD. "Even though there is merit to it, none of the studies
have backed it up tremendously." says Roseanne Schnoll, PhD, RD,
associate professor of nutrition at Brooklyn College of the City University
of New York.
Compared with white children, Hispanic and African-American
children were significantly less likely to receive an ADHD diagnosis from
kindergarten to eighth grade; the time pointspecific odds of a diagnosis

of ADHD peaked at third grade and declined subsequently. Furthermore,

Hispanic and African American children diagnosed with ADHD were less
likely to be using medication than were white children diagnosed with
ADHD.

ALCOHOL ABUSE AND DEPENDENCE

Alcohol abuse is described as any harmful use of alcohol that
causes either physical or mental damage. The Diagnostic and Statistical
Manual of Mental Disorders IV describes alcohol abusers as those who
drink despite recurrent social, interpersonal, and legal problems as a
result of alcohol use. Alcohol abuse is a major risk factor in developing
Alcoholism or alcohol dependence. Genetic predispositions from a family
history of alcoholism or due to a stressful change or personal issues
usually trigger alcohol dependence. Moreover, increase of ones alcohol
tolerance level could also contribute in its development. Developing
alcoholism is even greater if a person is a binge drinker, or someone who
drinks every day.
Hispanics tend to have this culture on drinking, that they start
having alcohol at an early age, and it is more prevalent than men at older
ages. Alcohol abuse and dependence is three times more likely to happen
with Hispanics than other ethnic groups. Hispanics are less likely to drink
at all than non-Hispanic Whites for they have high rates of abstinence
from alcohol, but those who choose to drink are more likely to consume
higher volumes of alcohol than non-Hispanic Whites.
ACCULTURATION
It is the process of adapting to the beliefs, values, and behaviors of a
new culture. A critical factor in predicting drinking patterns in the
Hispanic community is level of acculturation Assaf Ohsri stated that:
We tend to view acculturation stress as coming from the hosting
dominant culture. In fact, immigrant youth often have two or more
cultural identities they are trying to embrace at once, leading them to
experience dual stress, called bicultural stress.. and Enduring bicultural
stress during adolescencea vulnerable developmental phase in which
adolescents are still forming their own identityplaces them at risk for
participation in risk behaviors. We found that bicultural stress disrupts
their identity consolidation over time, which leads to increased
expectations that getting engaged with alcohol use would help them
alleviate or cope with this stress" (2014).
MEDIA

In todays generation, media has a big role in promoting and

introducing new things to the youth. It has also been a big factor in
contributing to the alcohol dependency and abuse of minors. One study in
John Hopkins University stated that the alcohol industry sees the
Hispanic population as an important market for their products. 10 alcohol
brands in the US in 2003 and 2004 have in fact, spent about $160 Million
to advertise their products in Spanish-language television.

BIPOLAR DISORDER
Bipolar disorder, also known as manic-depressive illness, is a brain
disorder that causes unusual shifts in mood, energy, activity levels, and
the ability to carry out day-to-day tasks. An estimated 2.3 million
Americans have bipolar disorder. Feelings that are extremely high (mania)
to exceedingly low (depression) are expected to be experienced by
someone who suffers from the illness. People with bipolar disorder can
control and manage these manias and depressions if properly treated.
Even though the rate of bipolar disorder is equal among Blacks and other
Americans, African Americans receive lesser diagnosis and treatment,
which makes the illness severe.
ACCESS TO TREATMENT
Bipolar disorders are really prevalent in African-American community.
There are no certain causes for its occurrence among blacks, but there
are some factors that affect it such as Brain Chemistry Genetics, Drug
and Alcohol Abuse, and Stressful or Disturbing Events. Most of them are
not receiving treatments due to some reasons like cultural barriers
between the patient and the doctor, reliance on family and religious
communities rather than mental health professionals during emotional
distress, socioeconomic factors that limits the access to mental and
medical health care (lack of health insurance), mistrust of health
professionals, continued misunderstanding and stigma about the illness,
etc.
HEREDITARY
Bipolar disorder is one for the hereditary disorders, as shown in careful
community studies among a representative of twins that focus not only
on people who seek treatment but those who may have cases that are
more severe than those who are not treated. A Finnish community-based
twin sample that used structured interviews to verify diagnoses obtained
a heritability estimate of 93 percent (Kieseppa et al., 2004). Adoption
studies also confirm the importance of heritability in bipolar disorder (e.g.,
Wender et al., 1986). This result verifies that genetics really has a great
effect among the population of twins in dealing with the disorder.

Adoption studies also confirm the importance of heritability in bipolar

disorder (e.g., Wender et al., 1986). In adoption, the foster parents may
not know the genetic history of the child, which may lead to the late
treatment in case the disorder would not be diagnosed earlier. Bipolar II
disorder is also highly heritable (Edvardsen et al., 2008). However,
Genetic models do not explain the timing of manic symptoms. Other
factors must be considered as the immediate triggers of symptoms.

DEPRESSION
Depression is more than the feelings of loneliness; it has an effect
in a victims whole body. Theres a rapid decline in energy and appetite,
uncontrolled feeling of guilt and fatigue, loss of concentration and the
worse is thoughts of suicide. Depression can occur to anyone, it does not
target a certain age, a certain race or ethnic group, it is felt all over the
world. However, studies show that it is more prevalent in Western people.
In a list released by The Richest: website of pop cultures and
current events and CBS News, America has topped the list of the most
depressed countries in the world. They have suggested a correlation of
this illness with the countrys large economy. In addition, U.S. spends
about $113 Billion on mental health treatment. Although this budget
decreases annually.
Diagnosis rates have a big significance in contributing to the notion
that African-Americans are less likely to trust doctors compared to
Whites.Complication in detection and diagnosis of depression among
minority patients are due to them showing physical aspects such as
sleeping problem and drug abuse rathen than symptoms in mood or
cognition.
DRUG ABUSE AND DEPENDENCE
According to a research of Substance Abuse and Mental Health
Administration in 1998, the surveys conducted on substance abuse
1992 and 1993 by National Household Surveys suggested that the
alcohol and drug abuse among Hispanic do not have much difference
whole U.S. Population.

Services
in 1991,
rates of
than the

In dealing with drug crimes, black youth has an arrest rate ten times
higher than whites. However, other research suggests that African Americans
are the least to use drugs and have a lower chance of developing substance use
disorders compared to Whites and Hispanic.
PARENTAL GUIDANCE
Drug use of Hispanic teenagers have a higher rate compared to Caucasian or
African-American adolescent, they have a tendency rate to use illegal drugs of
40% higher than Caucasians and 30% higher than Black teenagers.
Parental upbringing and guidance have an important role in dealing with
this mental disorder. According to a study conducted by Ortegal and colleagues
(2000), Hispanic teenagers receive little supervision from their parents. Their
actions are not monitored as well as their behavior; teenagers who experience
these are 4 times more likely to take illegal drugs.
GENETICS
Studies show that drug abuse is prevalent in Hispanic community. One of
the causes of drug abuse could be genetics. According to US Department of
Health and Human Services, genes can be a cause of drug abuse because genes
can participate in acquiring risk behaviors and personality development that will
affect the person in terms of reacting or responding to its environment, and
genes can affect the reactions of the body to the drug. Another reason for drug
abuse is the acculturation of the Hispanics. Hispanics are immigrants and they
may find it difficult to adapt to the culture and social patterns and practices.
Other factors are poverty issues.

GENERALIZED ANXIETY DISORDER

Generalized Anxiety Disorder is an illness in which a person suffers from
persistent and chronic worry that is hard to control. People with GAD may not
necessarily be provoked by specific triggers; they may worry about anything.
GAD is described as a "free-floating" kind of anxiety, which means it can cling
itself to numerous issues and concerns in the patient's environment.
Contrary to what is stated in the chart, Hispanics and Blacks have higher
rates of GAD than that of Whites. Socioeconomic status is one contributor that
may result to GAD. According to one study, GAD is more likely caused by a
gradual gathering of minor stressors than with demographic factors. People who
belong to the lower socioeconomic status have less resources for dealing with
minor stressors, making them more prone to developing GAD. Since treatment
for mental illness comes with high costs, Hispanics and Blacks' risk of severe
impairment is elevated.

PANIC DISORDER
Panic disorder is an illness in which panic attacks are recurrent and causes
extreme episodes of chronic anxiety. Panic Disorder often begins during late
adolescence and early adulthood. It is more prevalent in women than it is in
men. It may also come with changes in behavior, which can last at least a
month. It isn't the same as the fear and anxiety one feels towards stressful
events. It can affect daily functioning and general quality of life.
LACK OF DIAGNOSIS
Most Hispanics with Panic Disorder go undiagnosed. This can be a factor to
Panic Disorder as not getting help or medical care may heighten the threat of
developing mental disorders.
SUBSTANCE ABUSE
Substance Abuse can be a contributor in developing Panic Disorder.
Hispanics have the highest rate of Alcohol and Drug Abuse, which makes them
more susceptible in developing Panic Disorder.
ENVIRONMENTAL
Environment and surroundings also play a vital role in one's mental health. A
poor environment and exposure to vices and crimes, which is prevalent in
Hispanics, may contribute to Panic Disorder.

PTSD
When people experience accidents, natural catastrophes, violent
personal assaults or loss of a loved one, these cause emotional disorder
such as intense fear or horror and feeling of helplessness which will
possibly lead to posttraumatic stress disorder in which victims will
continue to experience fear after being exposed to traumatic event. PTSD
can be developed biologically and psychologically
In the past decade, Americans have experienced some of the worst
disasters in the world. One of which was on 11th of September in 2001,
the world has witnessed the bombing of World Trade Center and the
Pentagon. Surveys that were conducted in PTSD revealed that 3.5% of
citizens in United States experience PTSD annually and 7.9% suffer from
it during their lifetime (Taylor et al, 2010). In addition, only about 60% of
these individual seek treatment (Wang et al., 2005). It is important to
take note that Whites and minorities both experience these factors that
contribute to PTSD, however, Whites have a higher statistics in the
enumerated factors.

SOCIAL FACTOR

People are a social animal, meaning they tend to live in groups such
as families and friends; this factor make direct contributions to biology
and behavior of an individual. Getting support from people that matters
to an individual reduces cortisol secretion and hypothalamic-pituitaryadrenocortical axis which are responsible for regulating stress.
COMBAT

Being a soldier is one of the careers that are most vulnerable to

violence. They experience anxiety and depression during combat, Figley
(1978) stated that during World War I; soldiers experienced shell shock
and combat fatigue during World War II. These terms were created to
describe the reaction of the witnesses to the atrocities of the wars.
About 20% of the 16 million Americans deployed to the Afghanistan
and Iraq wars have showed symptoms of PTSD based on the large-scale
study completed in 2008 by a non-profit organization: RAND corporation
(Gerver, 2008). Furthermore, the traumatic events the soldiers have
witnessed are seeing colleagues and civilians seriously wounded or killed
and experiencing the injuries they themselves.
MOTOR VEHICLE ACCIDENTS

Blanchard & Hickling (2004) revealed that the most common

traumatic experience associated with PTSD is actually motor vehicle
accidents. Since transportation plays a big role in peoples everyday lives,
it is more likely that an individual get into these accidents. However,
victims of motor vehicle accidents are less likely to experience PTSD than
those who have gone through combat and physical assaults.

Prevalence of Depression among Caucasians

Depression is a mood disorder that causes a persistent feeling of sadness
and loss of interest. According to Faris (2012), it is a condition that had
reportedly affects one in ten Americans at one point or another, and the
incidence of depression is higher in some states than others. It has been
becoming a significant health concern worldwide.
Depression has many causes, it may be genetic, yet according to some
researches on mental health conditions, and it has been revealed that certain
lifestyle factors increased depression rates. Based from an article written by
Stephanie Faris, and medically reviewed by Dr. George Krucik, M.D., Individuals
with less than a high school education are more likely to suffer from depression

than those with a high school diploma or more advanced degree. Also, Faris
stated that involuntary unemploymentregardless of its causeis also elevated
among those reporting depression. Since depression is a leading cause of
disability in the U.S., it may lead to increased unemployment and decreased
quality of life. Lastly, those who have gone through a divorce have a higher risk
of depression. Statistics indicate that men are more likely than women to suffer
depression after a divorce. (2012)
Rates of depression differ according to gender, age, and ethnicity.
Researchers found out that women are twice as likely to have depression, and
symptoms of depression, as men of the same age. 12% of all women in the
United States will experience symptoms of clinical depression at some point in
their lives. Approximately one in ten women experience symptoms of depression
in the weeks after having a baby. The Behavioral Risk Factor Surveillance System
found that the rate of diagnosed major depression increased with age from 2.8%
for adults 18-24 to a peak of 4.6% for adults 45-64 years. 4% of adolescents will
develop significant symptoms of serious depression each year in the United
States. Suicide is the third leading cause of death among children and young
adults aged 10 to 24. For every 33 children in school, one child will have clinical
depression. Non-Hispanic blacks, Hispanics, and Non-Hispanic others had rates
of diagnosis of 4.0%, 4.0%, and 4.3%, respectively, and were more likely to
report depressive symptoms than non-Hispanics whites (3.1%). (Faris, 2012)
Persistent feeling of sadness and loss of interest in inevitable, but it may
be prevented to lead to depression. The necessity of prevention and cure for
depression is indeed evident, since it has becoming a significant health concern
not just in the United States but all over the world.
Source: http://www.healthline.com/health/depression/statistics#4

Prevalence of Alcohol Abuse among Hispanics

According to DSM-IV-TR, alcohol abuse or dependence is most prevalent
among the Latin Americans. Alcohol dependence is an alcohol use disorder often
characterized by craving or compulsion to drink, increased tolerance to alcohol,
withdrawal symptoms, including shaking, anxiety, or even seizures, and failed
attempts to quit that can result in drinking even greater amounts. According to
National Institute on Alcohol Abuse and Alcoholism (NIAAA) of USA, a standard

drink that is roughly 14 grams of pure alcohol, which is found in 12 ounces of

beer, 5 ounces of wine, and 1.5 ounces of distilled spirits, is considered too
much. Below is a representation of the average number of alcohol consumption
per week (beer, wine, and liquor) by country/nation of origin.

Average number of drinks per week (beer, wine, and liquor)

by country/nation of origin
Country/Nation of Origin
Puerto Rico
Mexico
South/Central America
Cuba

Average Number of
Average Number of
Drinks/Week for
Drinks/Week for Men
Women (irrespective
(irrespective of beverage)
of beverage)
16.9 (1.6)
9.5 (2.3)
15.9 (1.7)
3.0 (1.0)
8.9 (0.8)
3.8 (0.6)
8.4 (0.9)
3.4 (1.1)

SOURCE: Ramisetty-Mikler, S.; Caetano, R.; and Rodriguez, L.A. The Hispanic Americans Baseline Alcohol Survey(HABLAS):
Alcohol consumption and sociodemographic predictors across Hispanic national groups. Journal of Substance Use 15(6): 402
416, 2010.

There are certain factors, according to NIAAA, that predict drinking

behavior in the Hispanic Community: Acculturation, Gender, and Attitudes.
Acculturation is the process of adapting to the beliefs, values, and behaviors of a
new culture. American education all contribute to adapting to American culture.
But as acculturation levels increase, so can alcohol consumption. The evidence
is clear that as women become acculturated to American life, they tend to drink
more alcohol. There is mixed evidence of the same effect for men. In terms of
gender, women typically do not drink outside of small family gatherings or other
private settings. But as for the Hispanics in the United States, this cultural norm
is changing. Recent studies show some young Hispanic women are drinking as
much or even more than young Hispanic men. Research shows that young, U.S.born Hispanic men who are not Protestant tend to have relaxed attitudes toward
drinking. Those who feel this way also are more likely to drink, to drink heavily,
and to possibly have alcohol-related problems. Within the Hispanic community,
Puerto Ricans and Mexican Americans tend to have more relaxed attitudes about
drinking than Cuban Americans.
Source:
http://pubs.niaaa.nih.gov/publications/HispanicFact/HispanicFact.htm

Prevalence of Depression among African-Americans

Depression is a huge health concern among African-Americans -- particularly
women -- but mental health is often stigmatized in the black community.
Although it can impact people from all walks of life, cultural habits and historical

experiences can cause depression to be expressed and addressed differently

among black women. According to Esney M. Sharpe, founder and CEO of the
Bessie Mae Womans Health Center in East Orange, New Jersey, that during
slavery, African women were supposed to be the strong one. That they werent
supposed to speak and that they were supposed to just do.
Hamm (2014) suggested that lack of treatment, lack of health insurance,
shame and embarrassment, lack of knowledge, refusal of help, and hope, are
some of the factors as to why depression is prevalent among African-Americans
specifically women.
Hector M. Gonzalez, Ph.D., and colleagues at Wayne State University,
Detroit, found that overall, only about half of Americans diagnosed with major
depression in a given year receive treatment for it. But only one-fifth receive
treatment consistent with current practice guidelines. African-Americans had
some of the lowest rates of use of depression care.
A lack of adequate health care can significantly contribute to low rates of
the treatment of depression among African-Americans, particularly AfricanAmerican women. More than 20 percent of black Americans are uninsured
compared to less than 12 percent of whites. Diane R. Brown is a professor of
health education of behavioral science at the Rutgers School of Public Health
and co-author of, "In and Out of Our Right Minds: The Mental Health of AfricanAmerican Women." Her research shows a correlation between socioeconomic
status and poor physical and mental health. Since black women are more likely
to be poor, to be unmarried and to parent a child alone, which are all stressors
that can contribute to poor mental health, they are also least likely to have
resources like adequate mental health insurance to address problems such as
depression. (Hamm, 2014)
There is an extreme lack of knowledge about depression in AfricanAmerican communities due to the negative stigmas with regard to mental health
and depression. A research done by researchers at Mental Health America
suggest that African-Americans are more likely to believe depression is normal.
In fact, 56% of blacks believed that depression was a normal part of aging
according to a study made by Mental Health America on depression.
Hamm also stated that one of the great barriers to keeping black women
from receiving treatment for depression is a history of discrimination and a deep
mistrust of health care institutions in the U.S., which can cause black women to
refuse help when they need it.
Matthew Johnson, a licensed psychologist in New Jersey and faculty
member at John Jay College of Criminal Justice said, "Even though they are
facing racism and sexism that they are finding ways to care for themselves and
accommodate what they're faced with from external society and largely through
a lot of relationships and support systems that they built for themselves among
relatives and among friends."

Source:
http://www.huffingtonpost.com/nia-hamm/depression-africanamericanwomen_b_5836320.html