Psychosocial mechanisms underlying cultural differences in depressive and anxiety illness symptom reporting and presentation: comparison of Greek-born immigrants and Anglo-Australians

Abstract

The current research included three studies: a survey exploring psychological factors that may underly cultural differences in illness reporting and presentation; and a qualitative and a quantitative study exploring cultural differences in illness schemas. The purpose of the work is to examine the importance of a wide variety of factors that may underly cultural differences in the presentation and reporting of depression and anxiety. The total sample of respondents consisted of 221 Greek-born and 239 Anglo-Australian people (mean age 65 yrs). First, Greek-born people reported higher levels of depression (as measured by the Beck Depression Inventory-2, BD1-2) and anxiety (as measured by the State Trait Anxiety Inventory, STAI) and higher levels of stress, trait negative affectivity, illness concern, impression management, self-focused attention and stigma. Hierarchical regression analyses indicated that all explanatory variables were significant unique predictors of at least one BDI-2 and/or STAI measure when controlling for confounding variables such as socio-economic status, age and gender. Overall, Trait Negative Affectivity (TNA) was the most stable and consistent predictor of the BDI-2 and STAI scores for both birthplace groups. Conceptual similarities appear to exist for the causes and important symptoms components of illness schemas between mental and physical problems for the Greek-born. For the Anglo-Australians, similarities exist for the course and development, consequences and therapy components of illness schemas between mental, physical and social problems. The propensity to report particular types of symptoms to a doctor appeared to also be affected by illness schemas.

Findings suggest that different presentation of depression and anxiety across cultures may be better understood by the degree to which processes underlying symptom reporting may be salient in different cultures.