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Culture, Medicine, and Psychiatry

, Volume 36, Issue 3, pp 480–492 | Cite as

Susto, Coraje, and Abuse: Depression and Beliefs About Diabetes

  • Emily MendenhallEmail author
  • Alicia Fernandez
  • Nancy Adler
  • Elizabeth A. Jacobs
Original Paper

Abstract

Mexican immigrants in the US often incorporate folk beliefs into diabetes etiologies but little is known about the relationship between such beliefs and depression. This study examines the relationship of diabetes beliefs and depression among 404 first- and second-generation Mexican immigrants seeking diabetes care in safety-net clinics in Chicago and San Francisco. We used multivariate linear regression to compare the association of depression with beliefs that susto (fright), coraje (anger), and/or interpersonal abuse cause diabetes, adjusting for gender, age, income, education, diabetes duration, co-morbidities, language preference, and acculturation. We incorporated the belief that abuse causes diabetes based on previous ethnographic research. Individuals reporting belief that abuse contributes to diabetes were significantly more likely to report symptoms of depression before (β = 1.37; p < 0.05) and after adjustment (β = 2.03; p < 0.001). Believing that susto and/or coraje cause diabetes was not significantly associated with depression before or after adjustment. The significant association between depression and belief that abuse contributes to diabetes onset suggests that belief in a specific form of social distress may be more closely associated with depression among people with diabetes than a folk belief such as susto or coraje.

Keywords

Folk beliefs Depression Diabetes Abuse Stress Mexican immigrants 

Notes

Acknowledgments

We wish to thank the Russell Sage Foundation and the Commonwealth Fund for funding this article. In addition, Dr. Fernandez was partly supported by an award from the Arnold P. Gold Foundation.

References

  1. Ali, S., M. Stone, et al. (2006). “The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis.” Diabetic Medicine 23: 1165-1173.CrossRefGoogle Scholar
  2. Anderson, R. J., R. E. Clouse, et al. (2001). “The Prevalence of Comorbid Depression in Adults with Diabetes.” Diabetes Care 24(6): 1069-1078.CrossRefGoogle Scholar
  3. Baer, R. D., S. C. Weller, et al. (2003). “A Cross-Cultural Approach to the Study of the Folk Illness Nervios.” Culture, Medicine and Psychiatry 27(315-337).CrossRefGoogle Scholar
  4. Black, S. (1999). “Increased health burden associated with comorbid depression in older diabetic Mexican Americans. Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly Survey.” Diabetes Care 22(1): 56–64.CrossRefGoogle Scholar
  5. Chavez, L. R., F. A. Hubbell, et al. (1995). “Structure and Meaning in Models of Breast and Cervical Cancer Risk Factors: A Comparison of Perceptions Among Latinas, Anglo Women, and Physicians.” Medical Anthropology Quarterly 9(1): 40-74.CrossRefGoogle Scholar
  6. Coronado, G., B. Thompson, et al. (2004). “Attitudes and beliefs among Mexican Americans about type 2 diabetes.” Journal of Health Care for the Poor and Underserved 15(4): 576-588.CrossRefGoogle Scholar
  7. Cowie, C. C., K. F. Rust, et al. (2010). “Prevalence of Diabetes and High Risk for Diabetes using A1C Criteria in the U.S. Population in 1988-2006.” Diabetes Care 33(3): 562-568.CrossRefGoogle Scholar
  8. Cueller, I., B. Arnold, et al. (1995). “Acculturation rating scale for Mexican Americans II.” Hispanic Journal of Behavioral Sciences 17(3): 275-304.CrossRefGoogle Scholar
  9. deGroot, M., B. Pinkerman, et al. (2006). “Depression treatment and satisfaction in a multicultural sample of type 1 and type 2 diabetic patients.” Diabetes Care 29: 549-553.CrossRefGoogle Scholar
  10. Dohrenwend, B., M. Dodson, et al. (1984). “Symptoms, Hassles, Social Supports, and Life Events: Problem of Confounded Measures.” Journal of Abnormal Psychology 93(2): 222-230.CrossRefGoogle Scholar
  11. Egede, L. and C. Ellis (2010). “Diabetes and Depression: Global Perspectives.” Diabetes Research and Clinical Practice 87: 302-312.CrossRefGoogle Scholar
  12. Finkler, K. (1991). Physicians at Work, Patients in Pain: Biomedical Practice and Patient Response in Mexico. Boulder, CO, Westview Press.Google Scholar
  13. Finkler, K. (1994). Women in Pain: Gender and Morbidity in Mexico. Philadelphia, University of Philadelphia Press.Google Scholar
  14. Finkler, K. (1997). “Gender, Domestic Violence and Sickness in Mexico.” Social Science and Medicine 45(8): 1147-1160.CrossRefGoogle Scholar
  15. Garro, L. C. (2008). “Remembering what one knows and the construction of the past; A comparison of cultural knowledge of cultural consensus theory and cultural schema theory.” Ethos 28(3): 275-319.CrossRefGoogle Scholar
  16. Gilbody, S., D. Richards, et al. (2007). “Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis.” Journal of General Internal Medicine 22(11): 1596-1602.CrossRefGoogle Scholar
  17. Golden, S., M. Lazo, et al. (2008). “Examining a bidirectional association between depressive symptoms and diabetes.” Journal of the American Medical Association 299(23): 2751-2759.CrossRefGoogle Scholar
  18. Golden, S. H., B. L. H. Chang, et al. (2007). “Depression and Type 2 Diabetes Mellitus: The Multiethnic Study of Atherosclerosis.” Psychosomatic Medicine 69: 529-536.CrossRefGoogle Scholar
  19. Gonzalez, H. M., W. Tarraf, et al. (2010). The Epidemiology of Major Depression and Ethnicity in the United States. Journal of Psychiatric Research 44(15): 1043-1051.CrossRefGoogle Scholar
  20. Good, B. (1977). “The heart of what’s the matter: The semantics of illness in Iran.” Culture, Medicine, and Psychiatry 1: 25-58.CrossRefGoogle Scholar
  21. Good, M.-J. D., B. Good, et al. (1992). Pain as Human Experience: An Anthropological Perspective. Berkeley, University of California Press.Google Scholar
  22. Guarnaccia, P. J. (1992). “Ataque de nervios in Puerto Rico: Culture-bound Syndrome or Popular Illness?.” Medical Anthropology 15: 1-14.Google Scholar
  23. Kleinman, A. (1980). Patients and Healers in the Context of Culture: An Exploration of the borderland between Anthropology, Medicine and Psychiatry. Berkeley, University of California Press.Google Scholar
  24. Kleinman, A. (1988). The Illness Narratives: Suffering, Healing and the Human Condition. New York, Basic Books.Google Scholar
  25. Knol, M., J. Twisk, et al. (2006). “Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis.” Diabetologia 49(5): 837–845.CrossRefGoogle Scholar
  26. Low, S. M. (1989). Gender, Emotion, and Nervios in Urban Guatemala. In Gender, Health, and Illnesses: The case of Nerves. D.L. Davis, and S.M. Low, eds., pp. 115-140. New York: Hemisphere Publishing Co.Google Scholar
  27. Mattingly, C. and L. C. Garro (2000). Narrative and the Cultural Construction of Illness and Healing. Berkeley, University of California Press.Google Scholar
  28. Mendenhall, E., and E.A. Jacobs. (2012) Interpersonal Abuse and Depression among Mexican Immigrant Women with Type 2 Diabetes. Culture, Medicine and Psychiatry 36(1): 136-153.CrossRefGoogle Scholar
  29. Mendenhall, E., R. Seligman, et al. (2010) Speaking through Diabetes: Rethinking the Significance of Lay Discourses on Diabetes. Medical Anthropology Quarterly 24(2): 220–239.CrossRefGoogle Scholar
  30. Mercado-Martinez, F. J. and I. M. Ramos-Herrera (2002). “Diabetes: The Layperson’s Theories of Causality.” Qualitative Health Research 12(6): 792-806.Google Scholar
  31. Mezuk, B., W. Eaton, et al. (2008). “Depression and type 2 diabetes over the lifespan: a meta-analysis.” Diabetes Care 31(12): 2383–2390.CrossRefGoogle Scholar
  32. Musselman, D., E. Betan, et al. (2003). “Relationship of Depression to Diabetes Types 1 and 2: Epidemiology, Biology, and Treatment.” Biological Psychiatry 54: 317-329.CrossRefGoogle Scholar
  33. Nichter, M. (1981). “Idioms of Distress: Alternatives in the expression of psychosocial distress: A case study from South India.” Culture, Medicine and Psychiatry 5: 379-408.CrossRefGoogle Scholar
  34. Poss, J. and M. A. Jezewski (2002). “The role and meaning of susto in Mexican Americans’ explanatory model of type 2 diabetes.” Medical Anthropology Quarterly 16(3): 360-377.CrossRefGoogle Scholar
  35. Rubel, A. J., C. W. O’Nell, et al. (1984). Susto, A Folk Illness. Berkeley, University of California Press.Google Scholar
  36. Schoenberg, N., E. Drew, et al. (2005). “Situating Stress: Lessons from Lay Discourses on Diabetes.” Medical Anthropology Quarterly 19(2): 171-193.CrossRefGoogle Scholar
  37. Seligman, H., E. A. Jacobs, et al. (2011) Food Insecurity and Hypoglycemia among Safety Net Patients with Diabetes. Archives of Internal Medicine 17(13): 1204–1206.CrossRefGoogle Scholar
  38. Seligman, H., E. A. Jacobs, et al. (2012) Food Insecurity and Glycemic Control among Low-Income Patients with Type 2 Diabetes. Diabetes Care 35(2): 233-238.CrossRefGoogle Scholar
  39. Talbot, F. and A. Nouwen (2000). “A Review of the Relationship between Depression and Diabetes in Adults: Is There a Link?” Diabetes Care 23(10): 1556-1562.CrossRefGoogle Scholar
  40. Vijayaraghavan, M., E. Jacobs, et al. (2011). “The Association Between Housing Instability, Food Insecurity and Diabetes Self-Efficacy in Low-Income Adults.” Journal of Health Care for the Poor and Underserved 22(4): 1279-1291.CrossRefGoogle Scholar
  41. Weller, S., R. Baer, et al. (1999). “Latino Beliefs about Diabetes.” Diabetes Care 22(5): 722-728.CrossRefGoogle Scholar
  42. Weller, S., R. Baer, et al. (2002). “Regional variation in Latino descriptions of Susto.” Culture, Medicine and Psychiatry 26: 449-472.CrossRefGoogle Scholar
  43. Weller, S., R. Baer, et al. (2008). “Susto and Nervios: Expressions for Stress and Depression.” Culture, Medicine and Psychiatry 32: 406-420.CrossRefGoogle Scholar
  44. Wittkampf, K. A., L. Naeije, et al. (2007). “Diagnostic accuracy of the mood module of teh Patient Health Questionnaire: A systematic review.” General Hospital Psychiatry 29(5): 388-395.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Emily Mendenhall
    • 1
    Email author
  • Alicia Fernandez
    • 2
  • Nancy Adler
    • 3
  • Elizabeth A. Jacobs
    • 4
  1. 1.Department of AnthropologyNorthwestern UniversityEvanstonUSA
  2. 2.Department of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Departments of Psychiatry and Community HealthUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.Departments of Medicine & Population Health SciencesUniversity of Wisconsin School of Medicine & Public HealthMadisonUSA

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