Community Mental Health Journal

, Volume 55, Issue 2, pp 232–240 | Cite as

Psychological Distress Behavioral Patterns Among Latinos: We Don’t See Ourselves as Worthless

  • Armando BarragánEmail author
  • Ann-Marie Yamada
  • Tamika D. Gilreath
Original Paper


A cross-sectional study of 4921 Latinos from the National Health Interview Survey was conducted to examine behavioral patterns of psychological distress among Latinos. Latent class analysis was used to ascertain psychological distress behavioral profiles among Latinos. Analysis revealed four latent classes of distress, which included moderate psychological distress (13.6%); mild sadness, nervousness, and restlessness (13.0%); high psychological distress (2.8%); and no psychological distress (70.7%). Worthlessness, a widely-accepted dimension of distress, was not a significant behavioral trait. Results from the present study suggest that underlying cultural elements affect the subjective interpretations of symptoms reported by Latinos. These findings highlight distress profiles among Latinos and the possibility of overlooking behaviors that are uniquely indicative of distress, potentially leading to the underreporting of serious psychological distress in this population. Furthermore, these findings shed light on other paradoxical issues impacting the mental health of Latinos.


Psychological distress Latino mental health Public health Mental health assessment Culture 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was not obtained by the authors, since the data used in this study is made publically available by the National Center for Health Statistics and does not include identifying information.


  1. Agrawal, A., Lynskey, M. T., Madden, P. A. F., Bucholz, K. K., & Heath, A. C. (2006). A latent class analysis of illicit drug abuse/dependence: Results from the National Epidemiological Survey on Alcohol and Related Conditions. Addiction, 102(1), 94–104. Scholar
  2. Alegría, M., Canino, G., Stinson, F. S., & Grant, B. F. (2006). Nativity and DSM-IV psychiatric disorders among Puerto Ricans, Cubans Americans, and non-Latino Whites in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 67(1), 56–65. Scholar
  3. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd edn., revised). Washington, DC: American Psychiatric Association.Google Scholar
  4. Auerbach, K. J., & Collins, L. M. (2006). A multidimensional developmental model of alcohol use during emerging adulthood. Journal of Studies on Alcohol and Drugs, 67(6), 917–925. Scholar
  5. Barragán, A., Yamada, A. M., Lee, K. K., & Barrio, C. (2016). Correlates in the endorsement of psychotic symptoms and services use: Findings from the Collaborative Psychiatric Epidemiology Surveys. Community Mental Health Journal, 52(6), 631–642. Scholar
  6. Bratter, J. L., & Eschbach, K. (2005). Race/ethnic differences in nonspecific psychological distress: Evidence from the National Health Interview Survey. Social Science Quarterly, 86(3), 620–644. Scholar
  7. Canino, G., & Alegría, M. (2009). Understanding psychopathology among the adult and child Latino population from the United States and Puerto Rico: An epidemiologic perspective. In F. A. Villarruel, G. Carlo, J. M. Grau, M. Azmitia, N. J. Cabrera & T. J. Chahin (Eds.), Handbook of U.S. Latino psychology: Developmental and community-based perspectives (pp. 31–44). Thousand Oaks, CA: Sage. Scholar
  8. Castillo, R. J. (1997). Culture and mental illness: A client-centered approach. Pacific Grove, CA: Cengage Learning.Google Scholar
  9. Centers for Disease Control and Prevention. (2009). Web-based Injury Statistics Query and Reporting System (WISQARS): Fatal injury reports. Retrieved February 12, 2015, from
  10. Centers for Disease Control and Prevention. (2012). About the National Health Interview Survey. Retrieved February 2, 2015, from
  11. Centers for Disease Control and Prevention. (2014). Early release of selected estimates based on data from the January–September 2013 National Health Interview Survey. Retrieved February 9, 2015, from
  12. Connell, C. M., Gilreath, T. D., & Hansen, N. B. (2009). A multiprocess latent class analysis of the co-occurrence of substance use and sexual risk behavior among adolescents. Journal of Studies on Alcohol and Drugs, 70(6), 943–951. Scholar
  13. Dallo, F. J., Kindratt, T. B., & Snell, T. (2013). Serious psychological distress among non-Hispanic whites in the United States: The importance of nativity status and region of birth. Social Psychiatry and Psychiatric Epidemiology, 48(12), 1923–1930. Scholar
  14. Dohrenwend, B. P., Shrout, P. E., Ergi, G. E., & Mendelsohn, F. S. (1980). Nonspecific psychological distress and other dimensions of psychopathology: Measures for use in the general population. Archives of General Psychiatry, 37(11), 1229–1236. Scholar
  15. Draguns, J. G. (1990). Applications of cross-cultural psychology in the field of mental health. In R. W. Brislin (Ed.), Applied cross-cultural psychology (pp. 302–324). Newbury Park, CA: Sage. Scholar
  16. Drapeau, A., Beaulieu-Prévost, D., Marchand, A., Boyer, R., Préville, M., & Kairouz, S. (2010). A life-course and time perspective on the construct validity of psychological distress in women and men: Measurement invariance of the K6 across gender. BMC Medical Research Methodology, 10(68), 1–16. Scholar
  17. Drapeau, A., Marchand, A., & Beaulieu-Prévost, D. (2012). Epidemiology of psychological distress. In L. L’Abate (Ed.), Mental illnesses: Understanding, prediction and control (pp. 105–134). Rijeka: InTech. Scholar
  18. Gil, A. G., Vega, W. A., & Turner, R. J. (2002). Early and mid-adolescence risk factors for later substance abuse by African Americans and European Americans. Public Health Reports, 117(Supplement 1), S15–S29.Google Scholar
  19. Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P., & Anderson, K. (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic Whites in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(12), 1226–1233. Scholar
  20. Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Improving the K6 short scale to predict serious emotional disturbance in adolescents in the USA. International Journal Methods in Psychiatric Research, 19(Suppl. 1), 23–35. Scholar
  21. Guarnaccia, P. J. (1997). Social stress and psychological distress among Latinos in the United States. In I. Al-Isaa & M. Tousignant (Eds.), Ethnicity, immigration, and psychopathology (pp. 71–94). New York, NY: Plenum Press.Google Scholar
  22. Hendricks, P. S., Thorne, C. B., Clark, C. B., Coombs, D. W., & Johnson, M. W. (2015). Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology, 29(3), 280–288. Scholar
  23. Jedidi, K., Jagpal, H. S., & DeSarbo, W. S. (1997). Finite-mixture structural equation models for response-based segmentation and unobserved heterogeneity. Marketing Science, 16(1), 39–59. Scholar
  24. Jimenez, A. L., Alegría, M., Camino-Gaztambide, R. F., & Zayas, L. V. (2014). Cultural sensitivity: What should we understand about Latinos? In R. Parekh (Ed.), The Massachusetts General Hospital textbook on diversity and cultural sensitivity in mental health (pp. 61–88). New York, NY: Springer. Scholar
  25. Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. Scholar
  26. Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60(2), 184–189. Scholar
  27. Kim, G., Worley, C. B., Allen, R. S., Vinson, L., Crowther, M. R., Parmelee, P., & Chiriboga, D. A. (2011). Vulnerability of older Latino and Asian immigrants with limited English proficiency. Journal of the American Geriatrics Society, 59(7), 1246–1252. Scholar
  28. Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 671–694. Scholar
  29. Link, B. G., & Dohrenwend, B. P. (1980). Formation of hypotheses about the true relevance of demoralization in the United States. In B. P. Dohrenwend, B. S. Dohrenwend, M. S. Gould, B. Link, R. Neugebauer & R. Wunsch-Hitzig (Eds.), Mental illness in the United States: Epidemiological estimates (pp. 114–132). New York, NY: Praeger.Google Scholar
  30. Lo, C. C., Cheng, T. C., & Howell, R. J. (2014). Access to and utilization of health services as pathway to racial disparities in serious mental illness. Community Mental Health Journal, 50(3), 251–257. Scholar
  31. Magidson, J., & Vermunt, J. K. (2002). Latent class models for clustering: A comparison with K- means. Canadian Journal of Marketing Research, 20, 37–44.Google Scholar
  32. Maldonado-Denis, M. (1980). The emigration dialectic: Puerto Rico and the USA. New York, NY: International Publishers.Google Scholar
  33. McCutcheon, A. L. (1987). Latent class analysis. Beverly Hills, CA: Sage. Scholar
  34. McKelvey, R. S., Davies, L. C., Pfaff, J. J., Acres, J., & Edwards, S. (1998). Psychological distress and suicidal ideation among 15-24-year-olds presenting to general practice: A pilot study. Australian and New Zealand Journal of Psychiatry, 32(3), 344–348. Scholar
  35. McLean, J., Maxwell, M., Platt, S., Harris, F. M., & Jepson, R. (2008). Risk and protective factors for suicide and suicidal behaviour: A literature review. Retrieved from
  36. Mirowsky, J., & Ross, C. E. (1980). Minority status, ethnic culture, and distress: A comparison of Blacks, Whites, Mexicans, and Mexican Americans. American Journal of Sociology, 86(3), 479–495. Scholar
  37. National Comorbidity Survey. (2005). K10 and K6 scales. Retrieved September 11, 2014, from
  38. Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. Scholar
  39. Oquendo, M. A., Ellis, S. P., Greenwald, S., Malone, K. M., Weissman, M. M., & Mann, J. J. (2001). Ethnic and sex differences in suicide rates relative to major depression in the United States. American Journal of Psychiatry, 158(10), 1652–1658. Scholar
  40. Rivera, F. I., Guarnaccia, P. J., Mulvaney-Day, N., Lin, J. Y., Torres, M., & Alegría, M. (2008). Family cohesion and its relationship to psychological distress among Latino groups. Hispanic Journal of Behavioral Sciences, 30(3), 357–378. Scholar
  41. Roeder, K., & Wasserman, L. (1997). Practical Bayesian density estimation using mixtures of normals. Journal of the American Statistical Association, 92(439), 894–902. Scholar
  42. Sam, D. L., & Moreira, V. (2012). Revisiting the mutual embeddedness of culture and mental illness. Online Readings in Psychology and Culture, 10(2), 1. Scholar
  43. San Miguel, V. E. F., Guarnaccia, P. J., Shrout, P. E., Lewis-Fernández, R., Canino, G. J., & Ramírez, R. R. (2006). A quantitative analysis of ataque de nervios in Puerto Rico: Further examination of a cultural syndrome. Hispanic Journal of Behavioral Sciences, 28(3), 313–330. Scholar
  44. 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. Scholar
  45. Vega, W. A., & Gil, A. G. (2005). Revisiting drug progression: Long-range effects of early tobacco use. Addiction, 100(9), 1358–1369. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Social Work, College of Social and Behavioral ScienceCalifornia State University, San BernardinoSan BernardinoUSA
  2. 2.Suzanne Dworak-Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Transdisciplinary Center for Health Equity Research, Department of Health and Kinesiology, College of Education and Human DevelopmentTexas A&M UniversityCollege StationUSA

Personalised recommendations