title: An exploration of how psychotic-like symptoms are experienced, endorsed, and understood from the National Latino and Asian American Study and National Survey of American Life.
abstract: OBJECTIVE
  . To examine racial-ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African-Americans, Asians, Caribbean Blacks, and Latinos living in the USA.
  
  
  METHODS
  Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n > 100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms.
  
  
  RESULTS
  African-Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p < .001), but they endorsed auditory hallucinations symptoms more than Caribbean Blacks (43.1% and 25.7, p < .05). Endorsing delusions of reference and thought insertion/withdrawal were more prevalent for Latinos than for African-Americans (11% and 4.7%, p < .05; 6.3% and 2.7%, p < .05, respectively). Attribution themes included: supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms.
  
  
  CONCLUSIONS
  Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self-reported attributions/understandings for these symptoms on a psychosis screening instrument. Ethnic/racial differences could result from culturally sanctioned beliefs and idioms of distress that deserve more attention in conducting culturally informed and responsive screening, assessment and treatment.
authors.affiliation: a Public Health and Survey Research , ICF International , Atlanta , GA , USA.
authors.forename: Tara R
authors.initials: TR
authors.lastname: Earl
authors.forename: Lisa Roxanne
authors.initials: LR
authors.lastname: Fortuna
authors.forename: Shan
authors.initials: S
authors.lastname: Gao
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Harold
authors.initials: H
authors.lastname: Neighbors
authors.forename: David
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000523:psychology*; D017691:Caribbean Region / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology / Q000208:ethnology*; D014481:United States / Q000453:epidemiology
keywords: culture; delusions; ethnicity; hallucinations; psychotic symptoms; race; system endorsement