Skip to main content

Advertisement

SpringerLink
Log in

Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

Misdiagnoses of racial/ethnic minority youth’s mental health problems can potentially contribute to inappropriate mental health care. Therefore, we conducted a systematic review that focuses on current theory and empirical research in an attempt to answer the following two questions: (1) What evidence exists that supports or contradicts the idea that racial/ethnic minority youth’s mental health problems are misdiagnosed? (2) What are the sources of misdiagnoses? Articles were reviewed from 1967 to 2014 using PsychINFO, PubMed, and GoogleScholar. Search terms included “race”, “ethnicity”, “minority”, “culture”, “children”, “youth”, “adolescents”, “mental health”, “psychopathology”, “diagnosis”, “misdiagnosis”, “miscategorization”, “underdiagnosis”, and “overdiagnosis”. Seventy-two articles and book chapters met criteria and were included in this review. Overall, evidence was found that supports the possibility of misdiagnosis of ethnic minority youth’s emotional and behavioral problems. However, the evidence is limited such that it cannot be determined whether racial/ethnic differences are due to differences in psychopathology, mental health biases, and/or inaccurate diagnoses. Cultural and contextual factors that may influence misdiagnosis as well as recommendations for research and practice are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Acosta, F. X., Yamamoto, J., Evans, L. A., & Skilbeck, W. M. (1983). Preparing low-income Hispanic, Black, and White patients for psychotherapy: Evaluation of a new orientation program. Journal of Clinical Psychology, 39, 872–877.

    Article  PubMed  Google Scholar 

  • Alegria, M., Canino, G., Lai, S., Ramirez, R. R., Chavez, L., Rusch, D., & Shrout, P. E. (2004). Understanding caregivers’ help-seeking for Latino children’s mental health care use. Medical Care, 42, 447–455.

    Article  PubMed  Google Scholar 

  • Alegria, M., & McGuire, T. (2003). Rethinking a universal framework in the psychiatric symptom–disorder relationship. Journal of Health and Social Behavior, 44, 257–274.

    Article  PubMed  Google Scholar 

  • Alegria, M., Vallas, M., & Pumariega, A. J. (2010). Racial and ethnic disparities in pediatric mental health. Child and Adolescent Psychiatric Clinics of North America, 19, 759–774.

    Article  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Anderson, E. R., & Mayes, L. C. (2010). Race/ethnicity and internalizing disorders in youth: A review. Clinical Psychology Review, 30, 338–348.

    Article  PubMed  Google Scholar 

  • Angold, A., Erkanli, A., Farmer, E. M. Z., Fairbank, J. A., Burns, B. J., Keeler, G., & Costello, E. J. (2002). Psychiatric disorder, impairment, and service use in rural African American and White youth. Archives of General Psychiatry, 59, 893–904.

    Article  PubMed  Google Scholar 

  • Arcia, E., Castillo, H., & Fernandez, M. C. (2004). Maternal cognitions about distress and anxiety in young Latino children with disruptive behaviors. Transcultural Psychiatry, 41, 99–119.

    Article  PubMed  Google Scholar 

  • Arcia, E., Sanchez-LaCay, A., & Fernandez, M. C. (2002). When worlds collide: Dominican mothers and their Latina clinicians. Transcultural Psychiatry, 39, 74–96.

    Article  Google Scholar 

  • Brannan, A. M., Heflinger, C. A., & Bickman, L. (1997). The Caregiver Strain Questionnaire: Measuring the impact on the family of living with a child with serious emotional disturbance. Journal of Emotional and Behavioral Disorders, 5, 212–222.

    Article  Google Scholar 

  • Brown, C., Abe-Kim, J. S., & Barrio, C. (2003). Depression in ethnically diverse women: Implications for treatment in primary care settings. Professional Psychology: Research and Practice, 34, 10–19.

    Article  Google Scholar 

  • Budd, K. S., Madison, L. S., Itzkowitz, J. S., & George, C. H. (1986). Parents and therapists as allies in behavioral treatment of children’s stuttering. Behavior Therapy, 17, 538–553.

    Article  Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., & Erkanli, A. (1995). Children’s mental health service use across service sectors. Health Affairs, 14(3), 147–159.

    Article  PubMed  Google Scholar 

  • Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., & Landsverk, J. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 960–970.

    Article  PubMed  Google Scholar 

  • Canino, G., & Alegria, M. (2008). Psychiatric diagnosis—Is it universal or relative to culture? Journal of Child Psychology and Psychiatry, 49, 237–250.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cantwell, D. P., Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1997). Correspondence between adolescent report and parent report of psychiatric diagnostic data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 610–619.

    Article  PubMed  Google Scholar 

  • Cauce, A. M., Paradise, M., Domenech-Rodriguez, M., Cochran, B. N., Shea, J. M., Srebnik, D., & Baydar, N. (2002). Cultural and contextual influences in mental health help-seeking: A focus on ethnic minority youth. Journal of Consulting and Clinical Psychology, 70, 44–55.

    Article  PubMed  Google Scholar 

  • Charlop-Christy, M. H., & Carpenter, M. H. (2000). Modified incidental teaching sessions: A procedure for parents to increase spontaneous speech in their children with autism. Journal of Positive Behavior Interventions, 2, 98–112.

    Article  Google Scholar 

  • Combs-Orme, T., Chernoff, R. G., & Kager, V. A. (1991). Utilization of health care by foster children: Application of a theoretical model. Children and Youth Services Review, 13, 113–129.

    Article  Google Scholar 

  • Cook, B., McGuire, T., & Miranda, J. (2007). Measuring trends in mental health care disparities, 2000–2004. Psychiatric Services, 58, 1533–1540.

    Article  PubMed  Google Scholar 

  • Cook, B. L., Zuvekas, S. H., Carson, N., Wayne, G. F., Vesper, A., & McGuire, T. G. (2014). Assessing racial/ethnic disparities in treatment across episodes of mental health care. Health Services Research, 49, 206–229.

    Article  PubMed  PubMed Central  Google Scholar 

  • Costello, E. J., Farmer, E. M., & Angold, A. (1999). Same place, different children: White and American Indian children in the Appalachian mountains. In P. Cohen, C. Slomkowski, & L. N. Robins (Eds.), Historical and geographical influences on psychopathology. Mahwah, NJ: Lawrence Erlbaum Associates Publishers.

    Google Scholar 

  • Costello, E. J., Farmer, E. M., Angold, A., Burns, B. J., & Erkanli, A. (1997). Psychiatric disorders among American Indian and White youth in Appalachia: The Great Smoky Mountains Study. American Journal of Public Health, 87, 827–832.

    Article  PubMed  PubMed Central  Google Scholar 

  • Crane, D. R., Ngai, S. W., Larson, J. H., & Hafen, M. (2005). the influence of family functioning and parent–adolescent acculturation on North American Chinese adolescent outcomes. Family Relations, 54, 400–410.

    Article  Google Scholar 

  • Cuffe, S. P., Moore, C. G., & McKeown, R. E. (2005). Prevalence and correlates of ADHD symptoms in the National Health Interview Survey. Journal of Attention Disorders, 9, 392–401.

    Article  PubMed  Google Scholar 

  • Cummings, J. R., & Druss, B. G. (2011). Racial/ethnic differences in mental health service use among adolescents with major depression. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 160–170.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dang, M. T., Warrington, D., Tung, T., Baker, D., & Pan, R. J. (2007). A school-based approach to early identification and management of students with ADHD. Journal of School Nursing, 23, 2–12.

    Article  PubMed  Google Scholar 

  • Delbello, M. P., Lopez-Larson, M. P., Soutullo, C. A., & Strakwoski, S. M. (2001). Effects of race on psychiatric diagnosis of hospitalized adolescents: A retrospective chart review. Journal of Child and Adolescent Psychopharmacology, 11, 95–103.

    Article  PubMed  Google Scholar 

  • Duarte, C. S., Bird, H. R., Shrout, P. E., Wu, P., Lewis-Fernandez, R., Shen, S., & Canino, G. (2008). Culture and psychiatric symptoms in Puerto Rican children: Longitudinal results from one ethnic group in two contexts. Journal of Child Psychology and Psychiatry, 49, 563–572.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fabrega, H., Ulrich, R., & Mezzich, J. E. (1993). Do Caucasian and Black adolescents differ at psychiatric intake? Journal of the American Academy of Child and Adolescent Psychiatry, 32, 407–413.

    Article  PubMed  Google Scholar 

  • Fischer, A. R., Jome, L. M., & Atkinson, D. R. (1998). Reconceptualizing multicultural counseling: Universal healing conditions in a culturally specific context. Counseling Psychologist, 26, 525–588.

    Article  Google Scholar 

  • Furnham, A., & Malik, R. (1994). Cross-cultural beliefs about “Depression”. International Journal of Social Psychiatry, 40, 106.

    Article  PubMed  Google Scholar 

  • Garland, A., Landsverk, J., & Lau, A. (2003). Racial/ethnic disparities in mental health service use among children in foster care. Children and Youth Services Review, 25, 491–507.

    Article  Google Scholar 

  • Garland, A. F., Lau, A. S., Yeh, M., McCabe, K. M., Hough, R. L., & Landsverk, J. A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162(7), 1336–1343.

    Article  PubMed  Google Scholar 

  • Good, B. J., & Delvecchio-Good, M. J. (1982). Toward a meaning-centered analysis of popular illness categories: Fright illness and heart distress in Iran. In A. J. Marsella & G. M. White (Eds.), Cultural conceptions of mental health and therapy (pp. 141–166). Dordrecht: D. Reidel Publishing Company.

    Chapter  Google Scholar 

  • Guarnaccia, P. J., Lewis-Fernandez, R., & Marano, M. R. (2003). Toward a puerto Rican popular nosology: Nervios and ataque de nervios. Culture, Medicine and Psychiatry, 27, 339–366.

    Article  PubMed  Google Scholar 

  • Guarnaccia, P. J., Martinez, I., Ramirez, R., & Canino, G. (2005). Are ataques de nervios in Puerto Rican children associated with psychiatric disorder? Journal of American Academy of Child and Adolescent Psychiatry, 44, 1184.

    Article  Google Scholar 

  • Gudiño, O. G., Lau, A. S., Yeh, M., McCabe, K. M., & Hough, R. L. (2008). Understanding racial/ethnic disparities in youth mental health services: Do disparities vary by problem type? Journal of Emotional and Behavioral Disorders, 17, 3–16.

    Article  Google Scholar 

  • Harrison, M. E., McKay, M. M., & Bannon, W. M. (2004). Inner-city child mental health service use: The real question is why youth and families do not use services. Community Mental Health Journal, 40, 119–131.

    Article  PubMed  Google Scholar 

  • Hawley, K. M., & Weisz, J. R. (2003). Child, parent and therapist (dis)agreement on target problems in outpatient therapy: The therapist’s dilemma and its implications. Journal of Consulting and Clinical Psychology, 71, 62–70.

    Article  PubMed  Google Scholar 

  • Heflinger, C. A., & Humphreys, K. L. (2008). Identification and treatment of children with oppositional defiant disorder: A case study of one state’s public service system. Psychological Services, 5, 139–152.

    Article  Google Scholar 

  • Hillemeier, M. H., Foster, E. M., Heinrichs, B., Heier, B., & Conduct Problems Prevention Research Group. (2007). Racial differences in parental reports of attention-deficit/hyperactivity disorder behaviors. Journal of Developmental and Behavioral Pediatrics, 28, 353–361.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jensen, P. S., & Watanabe, H. (1999). Sherlock Holmes and child psychopathology assessment approaches: The case of the false-positive. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 138–146.

    Article  PubMed  Google Scholar 

  • Kaizar, E., Chisholm, D., Seltman, H., Greenhouse, J., & Kelleher, K. J. (2006). The role of care location in diagnosis and treatment of pediatric psychosocial conditions. Developmental and Behavioral Pediatrics, 27, 219–225.

    Article  Google Scholar 

  • Kanazawa, A., White, P. M., & Hampson, S. E. (2007). Ethnic variation in depressive symptoms in a community sample in Hawaii. Cultural Diversity and Ethnic Minority Psychology, 13, 35–44.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1989). Developmental psychopathology: Current research, issues, and directions. American Psychologist, Special Issue: Children and Their Development: Knowledge Base, Research Agenda, and Social Policy Application, 44, 180–187.

    Google Scholar 

  • Kendall, J., & Hatton, D. (2002). Racism as a source of health disparity in families with children with attention deficit hyperactivity disorder. Advances in Nursing Science, 25, 22–39.

    Article  PubMed  Google Scholar 

  • Kilgus, M. D., Pumariega, A. J., & Cuffe, S. P. (1995). Influence of race on diagnosis in adolescent psychiatric inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 67–72.

    Article  PubMed  Google Scholar 

  • Kirk, S. A. (2004). Are children’s DSM diagnoses accurate? Brief Treatment and Crisis Intervention, 4, 255–270.

    Article  Google Scholar 

  • Kirmayer, L. J. (2001). Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment. Journal of Clinical Psychiatry, 62, 22–30.

    PubMed  Google Scholar 

  • Kirmayer, L. J., & Young, A. (1998). Culture and somatization: Clinical, epidemiological, and ethnographic perspectives. Psychosomatic Medicine, 60, 420–430.

    Article  PubMed  Google Scholar 

  • Kleinman, A. (1988). Views: A window on mental health in China. American Scientist, 22–27.

  • Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88, 251–258.

    Article  PubMed  Google Scholar 

  • Kleinman, A., & Kleinman, J. (1991). Suffering and its professional transformation: Toward an ethnography of interpersonal experience. Culture, Medicine and Psychiatry, 15, 275–301.

    Article  PubMed  Google Scholar 

  • Krueger, R. F., Chentsova-Dutton, Y. E., Markon, K. E., Goldberg, D., & Ormel, J. (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology, 112, 437–447.

    Article  PubMed  Google Scholar 

  • Kung, W. W. (2001). Consideration of cultural factors in working with Chinese American families with a mentally ill patient. Family Socialization, 82, 97–107.

    Article  Google Scholar 

  • Kung, W. W., & Lu, P. C. (2008). How symptom manifestations affect help seeking for mental health problems among Chinese Americans. The Journal of Nervous and Mental Disease, 196, 46–54.

    Article  PubMed  Google Scholar 

  • Kuno, E., & Rothbard, A. B. (2005). The effect of income and race on quality of psychiatric care in community mental health centers. Community Mental Health Journal, 41, 613–622.

    Article  PubMed  Google Scholar 

  • Kupst, M. J., & Shulman, J. L. (1979). Comparing professional and lay expectations of psychotherapy. Psychotherapy: Theory, Research and Practice, 16, 237–243.

    Article  Google Scholar 

  • Lambert, M. C., Rowan, G. T., Lyubansky, M., & Russ, C. M. (2002). Do problems of clinic-referred African-American children overlap with the Child Behavior Checklist? Journal of Child and Family Studies, 11, 271–285.

    Article  Google Scholar 

  • Lau, A. S., Garland, A. F., Yeh, M., McCabe, K. M., Wood, P. A., & Hough, R. L. (2004). Race/ethnicity and inter-informant agreement in assessing adolescent psychopathology. Journal of Emotional and Behavioral Disorders, 12, 145–156.

    Article  Google Scholar 

  • Leal, C. C. (2005). Stigmatization of Hispanic children, pre-adolescents, and adolescents with mental illness: Exploration using a national database. Issues in Mental Health Nursing, 26, 1025–1041.

    Article  PubMed  Google Scholar 

  • Lecrubier, Y. (2001). Prescribing patterns for depression and anxiety worldwide. Journal of Clinical Psychiatry, 62, 31–36.

    PubMed  Google Scholar 

  • Leung, P. W. L., & Wong, M. M. T. (2003). Measures of child and adolescent psychopathology in Asia. Psychological Assessment, 15, 268–279.

    Article  PubMed  Google Scholar 

  • Lewczyk, C. M., Garland, A. F., Hurlburt, M. S., Gearity, J., & Hough, R. L. (2003). Comparing DISC-IV and clinician diagnoses among youths receiving public mental health services. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 349–356.

    Article  PubMed  Google Scholar 

  • Lewis-Fernandez, R., & Diaz, N. (2002). The cultural formulation: A method for assessing cultural factors affecting the clinical encounter. Psychiatric Quarterly, 73, 271–295.

    Article  PubMed  Google Scholar 

  • Lin, K., Lau, J. K., Yamamoto, J., Zheng, Y., Kim, H. S., Cho, K. H., & Nakasaki, G. (1992). Hwa-byung: A community study of Korean Americans. Journal of Nervous and Mental Disease, 180, 386–391.

    Article  PubMed  Google Scholar 

  • Lopez, S. R., & Guarnaccia, P. J. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571–598.

    Article  PubMed  Google Scholar 

  • Mackin, P., Targum, S. D., Kalali, A., Rom, D., & Young, A. H. (2006). Culture and assessment of manic symptoms. British Journal of Psychiatry, 189, 379–380.

    Article  PubMed  Google Scholar 

  • Maeda, F., & Nathan, J. H. (1999). Understanding Taijin Kyofusho through its treatment, Morita therapy. Journal of Psychosomatic Research, 46, 525–530.

    Article  PubMed  Google Scholar 

  • Mak, W., & Rosenblatt, A. (2002). Demographic influences on psychiatric diagnoses among youth served in California systems of care. Journal of Child and Family Studies, 11, 165–178.

    Article  Google Scholar 

  • Malgady, R. G. (1996). The question of cultural bias in assessment and diagnosis of ethnic minority clients: Let’s reject the null hypothesis. Professional Psychology: Research and Practice, 27, 73–77.

    Article  Google Scholar 

  • Mallinckrodt, B., Shiegoka, S., & Suzuki, L. A. (2005). Asian and Pacific Island American students’ acculturation and etiology beliefs about typical counseling presenting problems. Cultural Diversity and Ethnic Minority Psychology, 3, 227–238.

    Article  Google Scholar 

  • Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism Development Disorder, 37, 1795–1802.

    Article  Google Scholar 

  • Maniadaki, K., Sonuga-Barke, E., Kakouros, E., & Karaba, R. (2006). Parental beliefs about the nature of ADHD behaviours and their relationship to referral intentions in preschool children. Child: Care, Health and Development, 33, 188–195.

    Google Scholar 

  • Manson, S. M. (2000). Mental health services for American Indians and Alaskan Natives: Need, use and barriers to effective care. Canadian Journal of Psychiatry, 45, 617–626.

    PubMed  Google Scholar 

  • Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98, 224–253.

    Article  Google Scholar 

  • Marsella, A. J., & Kaplan, A. (2002). Cultural considerations for understanding, assessing, and treating depressive experience and disorder. In M. Reinecke & M. Davison (Eds.), Comparative treatments of depression (pp. 47–48). New York: Springer.

    Google Scholar 

  • Mash, E. J., & Dozois, D. J. A. (2003). Child psychopathology: A developmental-systems perspective. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (2nd ed., pp. 3–71). New York: Guilford Press.

    Google Scholar 

  • McDonald, E. J., McCabe, K., Yeh, M., Lau, A., Garland, A., & Hough, R. (2005). Cultural affiliation and self-esteem as predictors of internalizing symptoms among Mexican American Adolescents. Journal of Clinical and Adolescent Psychology, 34, 163–171.

    Article  Google Scholar 

  • McKay, M. M., Pennington, J., Lynn, C. J., & McCadam, K. (2001). Understanding urban child mental health service use: Two studies of child, family, and environmental correlates. The Journal of Behavioral Health Services & Research, 28, 475–483.

    Article  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989.

    Article  PubMed  PubMed Central  Google Scholar 

  • Minnis, H., Kelly, E., Bradby, H., Oglethorpe, R., Raine, W., & Cockburn, D. (2003). Cultural and language mismatch: Clinical complications. Clinical Child Psychology and Psychiatry, 8, 179–186.

    Article  Google Scholar 

  • Minsky, S., Petti, T., Gara, M., Vega, W., Lu, W., & Kiely, G. (2006). Ethnicity and clinical psychiatric diagnosis in childhood. Administration and Policy in Mental Health & Mental Health Services Research, 33, 558–567.

    Article  Google Scholar 

  • Miranda, J., & Cooper, L. A. (2004). Disparities in care for depression among primary care patients. Journal of General Internal Medicine, 19, 120–126.

    Article  PubMed  PubMed Central  Google Scholar 

  • Morrissey-Kane, E., & Prinz, R. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2, 183–198.

    Article  PubMed  Google Scholar 

  • Muroff, J., Edelsohn, G. A., Joe, S., & Ford, B. C. (2008). The role of race in diagnostic and disposition decision making in a pediatric psychiatric emergency service. General Hospital Psychiatry, 30, 269–276.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Institute of Mental Health. (2001). National Institute of Mental Health five year strategic plan for reducing health disparities. Retrieved October 12, 2005, from http://www.nimh.nih.gov/strategic/healthdisparities.pdf.

  • Neighbors, H. W., Trierweiler, S. J., Ford, B. C., & Muroff, J. R. (2003). Racial differences in DSM diagnosis using a semi-structured instrument: The importance of clinical judgment in the diagnosis of African Americans. Journal of Health and Social Behavior, 43, 237–256.

    Article  Google Scholar 

  • Nguyen, L., Arganza, G. F., Huang, L. N., Liao, Q., Nguyen, H. T., & Santiago, R. (2004). Psychiatric diagnoses and clinical characteristics of Asian American youth in children’s services. Journal of Child and Family Studies, 13, 483–495.

    Article  Google Scholar 

  • Nguyen, L., Huang, L. N., Arganza, G. F., & Liao, Q. (2007). The influence of race and ethnicity on psychiatric diagnoses and clinical characteristics of children and adolescents in children’s services. Cultural Diversity and Ethnic Minority Psychology, 13, 18–25.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • O’Keefe, M., Mennen, F., & Lane, C. J. (2006). An examination of the factor structure for the youth self report on a multiethnic population. Research on Social Work Practice, 16, 315.

    Article  Google Scholar 

  • Okazaki, S., & Sue, S. (1995). Methodological issues in assessment research with ethnic minorities. Psychological Assessment, 3, 367–375.

    Article  Google Scholar 

  • Okazaki, S., & Sue, S. (2000). Implications of test revisions for assessment with Asian Americans. Psychological Assessment, 12, 272.

    Article  PubMed  Google Scholar 

  • Olson, P. M., & Pacheco, M. R. (2005). Bipolar disorder in school-age children. Journal of School Nursing, 21, 152–157.

    Article  PubMed  Google Scholar 

  • Oppedal, B., Roysamb, E., & Heyerdahl, S. (2005). Ethnic group, acculturation, and psychiatric problems in young immigrants. Journal of Child Psychology and Psychiatry, 46, 646–660.

    Article  PubMed  Google Scholar 

  • Oquendo, M. A. (1994). Differential diagnosis of ataque de nervios. American Journal of Orthopsychiatry, 65, 60–65.

    Article  Google Scholar 

  • Pang, K. Y. (1990). Hwabyung: The construction of a Korean popular illness among Korean elderly immigrant women in the United States. Culture, Medicine and Psychiatry, 14, 495–512.

    Article  PubMed  Google Scholar 

  • Patel, N. C., Delbello, M. P., & Strakowski, S. M. (2006). Ethnic differences in symptom presentation of youths with bipolar disorder. Bipolar Disorders, 8, 95–99.

    Article  PubMed  Google Scholar 

  • Phan, T., & Silove, D. (1997). The influence of culture on psychiatric assessment: The Vietnamese refugee. Psychiatric Services, 48, 86–90.

    Article  PubMed  Google Scholar 

  • Pope-Davis, D. B., Liu, W. M., Toporek, R. L., & Brittan-Powell, C. S. (2001). What’s missing from multicultural competency research: Review, introspection, and recommendations. Cultural Diversity and Ethnic Minority Psychology, 7, 121–138.

    Article  PubMed  Google Scholar 

  • Porter, N., Garcia, M., Jackson, H., & Valdez, D. (1997). The rights of children and adolescents of color in mental health systems. Women & Therapy, 20, 57–74.

    Article  Google Scholar 

  • Pottick, K. J., Kirk, S. A., Hsieh, D. K., & Tian, X. (2007). Judging mental disorder in youths: Effects of client, clinician, and contextual differences. Journal of Consulting and Clinical Psychology, 75, 1.

    Article  PubMed  Google Scholar 

  • Pottick, K. J., Lerman, P., & Micchelli, M. (1992). Of problems and perspectives: Predicting the use of mental health services by parents of urban youth. Children and Youth Services Review, 14, 363–378.

    Article  Google Scholar 

  • Reijneveld, S. A., Harland, P., Brugman, E., Verhulst, F. C., & Verloove-Vanhorick, S. P. (2005). Psychosocial problems among immigrant and non-immigrant children: Ethnicity plays a role in their occurrence and identification. European Child Adolescent Psychiatry, 14, 145–152.

    Article  PubMed  Google Scholar 

  • Reimher, J. P., & McClellan, J. M. (2004). Diagnostic challenges with children and adolescents with psychotic disorders. Journal of Clinical Psychiatry, 65, 5–11.

    Google Scholar 

  • Roberts, R. E., Roberts, C. R., & Xing, Y. (2006). Prevalence of youth-reported DSM-IV psychiatric disorders among African, European, and Mexican American adolescents. Journal American Academy of Child and Adolescent Psychiatry, 45, 1329–1337.

    Article  Google Scholar 

  • Roessner, V., Becker, A., Rothenberger, A., Rohde, L. A., & Banaschewski, T. (2007). A cross-cultural comparison between samples of Brazilian and German children with ADHD/HD using the Child Behavior Checklist. European Archives of Psychiatry and Clinical Neuroscience, 257, 352–359.

    Article  PubMed  Google Scholar 

  • Schmitz, M. F., & Velez, M. (2003). Latino cultural differences in maternal assessments of Attention Deficit/Hyperactivity symptoms in children. Hispanic Journal of Behavioral Sciences, 25, 110–122.

    Article  Google Scholar 

  • Shaffer, D., Fisher, P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-Stone, M. E., et al. (1996). The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of American Academy of Child Adolescent Psychiatry, 35, 865–877.

    Article  Google Scholar 

  • Short, A. B. (1984). Short-term treatment outcome using parents as co-therapists for their own autistic children. Journal of Child Psychology and Psychiatry, 25, 443–458.

    Article  PubMed  Google Scholar 

  • Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: Institute of Medicine of the National Academies, National Academies Press.

    Google Scholar 

  • Spencer, M. S., Fitch, D., Grogan-Kaylor, A., & McBeath, B. (2005). The equivalence of the behavior problem index across U.S. ethnic groups. Journal of Cross-Cultural Psychology, 36, 573–589.

    Article  Google Scholar 

  • Stein, D. J., & Matsunaga, H. (2001). Cross-cultural aspects of social anxiety disorder. Psychiatric Clinics of North America, 24, 773–782.

    Article  PubMed  Google Scholar 

  • Stevens, G. W. J. M., & Vollebergh, W. A. M. (2008). Mental health in migrant children. Journal of Child Psychology and Psychiatry, 49, 276–294.

    Article  PubMed  Google Scholar 

  • Strakowsky, S. M., Hawkins, J. M., Keck, P. E, Jr, McElroy, S. L., West, S. A., Bourne, M. L., et al. (1997). The effects of race and information variance on disagreement between psychiatric emergency service and research diagnoses in first-episode psychosis. Journal of Clinical Psychiatry, 58, 457–463.

    Article  Google Scholar 

  • Sue, D. W. (1994). Asian American mental health and help-seeking behavior: Comment on Solberg et al. (1994), Tata and Leong (1994), and Lin (1994). Journal of Counseling Psychology, 41, 292–295.

    Article  Google Scholar 

  • Sue, S. (1998). In search of cultural competence in psychotherapy and counseling. American Psychologist, 53, 440–448.

    Article  PubMed  Google Scholar 

  • Sue, S., Fujino, D. C., Hu, Li, Takeuchi, D. T., & Zane, N. W. S. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–540.

    Article  PubMed  Google Scholar 

  • Takeuchi, D. T., Chung, R. C. Y., Lin, K. M., Shen, H., Kurasaki, K., Chun, C. A., & Sue, S. (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry, 155(10), 1407–1414.

    Article  PubMed  Google Scholar 

  • Takeuchi, D. T., Mokuau, N., & Chun, C. A. (1992). Mental health services for Asian Americans and Pacific Islanders. The Journal of Mental Health Administration, 19, 237–245.

    Article  PubMed  Google Scholar 

  • Tarumi, S., Ichimiya, A., Yamada, S., Umesue, M., & Kuroki, T. (2004). Taijin Kyofusho in university students: Patterns of fear and predispositions to the offensive variant. Transcultural Psychiatry, 41, 533–546.

    Article  PubMed  Google Scholar 

  • Titzmann, P. F., Raabe, T., & Silbereisen, R. K. (2008). Risk and protective factors for delinquency among male adolescent immigrants at different stages of the acculturation process. International Journal of Psychology, 43, 19–31.

    Article  PubMed  Google Scholar 

  • Tolmac, J., & Hodes, M. (2004). Ethnic variation among adolescent psychiatric in-patients with psychotic disorders. British Journal of Psychiatry, 184, 428–431.

    Article  PubMed  Google Scholar 

  • Triandis, H. C. (1995). Individualism and collectivism. Boulder CO: Westview Press.

    Google Scholar 

  • Tyson, E. H., & Glisson, C. (2005). A cross-ethnic validity study of the shortform assessment for children (SAC). Research on Social Work Practice, 15, 97.

    Article  Google Scholar 

  • Uba, L. (1994). Asian Americans: Personality patterns, identity, and mental health. New York, NY: Guilford Press.

    Google Scholar 

  • Uehara, E. S., Takeuchi, D. T., & Smukler, M. (1994). Effects of combining disparate groups in the analysis of ethnic differences: Variations among Asian American mental health service consumers in level of community functioning. American Journal of Community Psychology, 22, 83–99.

    Article  PubMed  Google Scholar 

  • U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

    Book  Google Scholar 

  • U.S. Public Health Service. (2000). Report of the surgeon general’s conference on children’s mental health: A national action agenda. Washington, DC: Department of Health and Human Services.

    Google Scholar 

  • Varela, R. E., Vernberg, E. M., Sanchez-Sosa, J. J., Riveros, A., Mitchell, M., & Mashunkashey, J. (2004). Anxiety reporting and culturally associated interpretation biases and cognitive schemas: A comparison of Mexican, Mexican American, and European American families. Journal of Clinical Child and Adolescent Psychology, 33, 237–247.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., McCarty, C. A., Eastman, K. L., Suwanlert, S., & Chaiyasit, W. (1997). Developmental psychopathology and culture: Ten lessons from Thailand. In S. S. Luthar, J. Burack, D. Cicchetti, & J. R. Weisz (Eds.), Developmental psychopathology: Perspectives on adjustment, risk, and disorder (pp. 568–592). Cambridge: Cambridge University Press.

    Google Scholar 

  • Weisz, J. R., Suwanlert, S., Chaiyasit, W., Weiss, B., Walter, B. R., & Anderson, W. W. (1988). Thai and American perspectives on over-and undercontrolled child behavior problems: Exploring the threshold model among parents, teachers, and psychologists. Journal of Consulting and Clinical Psychology, 56(4), 601.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., & Weiss, B. (1991). Studying the “referability” of child clinical problems. Journal of Consulting and Clinical Psychology, 59, 266–273.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Weiss, B., Suwanlert, S., & Chaiyasit, W. (2006). Culture and youth psychopathology: Testing the syndromal sensitivity model in Thai and American adolescents. Journal of Consulting and Clinical Psychology, 6, 1098–1107.

    Article  Google Scholar 

  • White, K. S., & Farrell, A. D. (2006). Anxiety and psychosocial stress as predictors of headache and abdominal pain in urban early adolescents. Journal of Pediatric Psychology, 31, 582–596.

    Article  PubMed  Google Scholar 

  • Yeh, M., McCabe, K., Hurlburt, M., Hough, R., Hazen, A., Culver, S., et al. (2002). Referral sources, diagnoses, and service types of youth in public outpatient mental health care: A focus on ethnic minorities. The Journal of Behavioral Health Services & Research, 29, 45–60.

    Article  Google Scholar 

  • Yeh, M., & Weisz, J. R. (2001). Why are we here at the clinic? Parent–child (dis)agreement on referral problems. Journal of Consulting and Clinical Psychology, 69, 1018–1025.

    Article  PubMed  Google Scholar 

  • Ying, Y. W. (1988). Depressive symptomatology among Chinese–Americans as measured by the CES-D. Journal of Clinical Psychology, 44, 739–746.

    Article  PubMed  Google Scholar 

  • Youngstrom, E., Meyers, O., Youngstrom, J. K., Calabrese, J. R., & Findling, R. L. (2006). Diagnostic and measurement issues in the assessment of pediatric bipolar disorder: Implications for understanding mood disorder across the life cycle. Development and Psychopathology, 18(04), 989–1021.

    Article  PubMed  Google Scholar 

  • Zane, N., Sue, S., Chang, J., Huang, L., Huang, J., Lowe, S., et al. (2005). Beyond ethnic match: Effects of client-therapist cognitive match in problem perception, coping orientation, and therapy goals on treatment outcomes. Journal of Community Psychology, 33, 569–585.

    Article  Google Scholar 

  • Zheng, Y., Lin, K., Takeuchi, D., Kurasaki, K. S., Wang, Y., & Cheung, F. (1997). An epidemiological study of neurasthenia in Chinese–Americans in Los Angeles. Comprehensive Psychiatry, 38, 249–259.

    Article  PubMed  Google Scholar 

  • Zwirs, B. W. C., Burger, H., Schulpen, T. W. J., & Buitelaar, J. K. (2006). Different treatment thresholds in Non-Western children with behavioral problems. Journal American Academy of Child Adolescent Psychiatry, 45, 476–483.

    Article  Google Scholar 

  • Zwirs, B. W. C., Burger, H., Schulpen, T. W. J., Wiznitzer, M., Fedder, H., & Buitelaar, J. K. (2007). Prevalence of psychiatric disorders among children of different ethnic origin. Journal of Abnormal Child Psychology, 33, 556–566.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. May Yeh, Associate Professor at San Diego State University, for her mentorship and guidance in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of California, San Diego, 8950 Villa La Jolla Drive, Suite C203, La Jolla, CA, 92037, USA

    June Liang, Brittany E. Matheson & Jennifer M. Douglas

  2. San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA

    Brittany E. Matheson & Jennifer M. Douglas

Authors
  1. June Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brittany E. Matheson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer M. Douglas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to June Liang.

Ethics declarations

Conflict of interest

We have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liang, J., Matheson, B.E. & Douglas, J.M. Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth. J Child Fam Stud 25, 1926–1940 (2016). https://doi.org/10.1007/s10826-015-0351-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-015-0351-z

Keywords

Search

Navigation