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Title: NORTHERN PLAINS INDIANS: CULTURAL IDENTITY AND LIFESTYLE FACTORS IN DEPRESSION

Author
item GRAY, JACQUELINE - UNIV OF NORTH DAKOTA
item Penland, James
item Lambert, Patty
item Wilson, Ellen
item GONZALEZ, JOHN - UNIV OF NORTH DAKOTA
item Lukaski, Henry

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 8/3/2005
Publication Date: 8/18/2005
Citation: Gray, J.S., Penland, J.G., Lambert, P., Wilson, E.L., Gonzalez, J., Lukaski, H.C. 2005 Northern Plains Indians: Cultural identity and lifestyle factors in depression. Presented by Jacqueline S. Gray at the Annual Meeting of the American Psychological Association. Washington, DC. August 18-21, 2005.

Interpretive Summary:

Technical Abstract: Introduction According to a recent report by the U.S. Surgeon General (DHHS, 2001). American Indians (AI) and Alaska Natives are among the most impoverished of today’s minority groups and one of the most heterogeneous with over 560 federally recognized tribes and villages. The report also indicates that the diversity and small size of the AI population, and the rural and isolated locations of AI reservations, limit needed research. Depression is estimated to be the leading cause of disability worldwide (Murray and Lopez, 1996). AI have the highest per capita suicide rate in the U.S. at 247% the national average and, among 15-24 year olds, 429% the national average (IHS, 2000). There is little research regarding the co-morbidity of diabetes and depression and other mental health problems among AI (Daniels et al., 2001; Daniels et al., 2000). Further, the CES-D has been the most commonly used measure of depression in research with AI. However, mental health practitioners more frequently use the BDI-II, for which there are no norms for AI and validity has not been determined with this population. Participants Participants were 458 Northern Plains Indians (from the Dakotas, Minnesota, Montana, and Wyoming; 282 women; 175 men) attending powwows and health fairs. More than 96% were Dakota and Lakota Sioux from Spirit Lake and Standing Rock; Mandan, Hidatsa and Arikara (Three Affiliated Tribes) from Ft. Berthold; and Chippewa/Ojibwa from Turtle Mountain, White Earth and Trenton Indian Service Area. The mean age was 38 years (sd = 14.1 yrs) ranging between 18 and 78 years. Their education ranged from not finishing high school (n=36) to graduate or professional degrees (n=26), with 140 finishing high school, 206 having education beyond high school, and 40 having bachelor’s degrees. Marital status included 208 who were single, 139 married, 75 separated or divorced, 20 widowed, and 15 in living situations. Methods Participants were solicited through a mobile research lab located at native events. Self-report questionnaires were completed, height, weight, and blood pressure measured, and body mass index calculated. Participants completed questionnaires themselves or were asked the questions verbally. Some were assisted by family members. Each received a bag of hand-harvested wild rice, a bottle of ice water, and health education materials for participating. Prior to data collection this project was approved by the responsible tribal councils, powwow committees and college presidents, and by the UND IRB. Instruments The assessments included measures of depression and other aspects of mental health, quality of life, and acculturation. Beck Depression Inventory-II (Beck, Steer, Ball, & Ranieri, 1996) is a 21-item measure of depression considered the most widely used self-report instrument for measuring depressive symptom severity in both research and clinical settings (Nezu, Ronan, Meadows, & McClure, 2000). The maximum score is 63 and higher scores indicate higher levels of depressive symptoms (norm alpha was 0.93; alpha for study sample was 0.90). Center for Epidemiological Studies-Depression (Radloff, 1977) is a 20-item measure of depressive symptoms. The CES-D was developed to be used in epidemiological studies of depression, not to diagnose or measure symptom severity, and has been used with AI (Beals, Manson, Keane, & Dick, 1991; Kirmayer, Dick, Beals, Keane, & Manson, 1994; Manson, Ackerman, Dick, Baron, & Fleming, 1990; Somervell et al., 1992, 1993). Scores range from 0-60, with higher scores indicating more depressive symptoms. Developers use a cut off score of 16 to differentiate depressed from non-depressed participants (Norm alpha = 0.85; study sample alpha= 0.86) (Comstock & Helsing, 1976). Symptom Checklist-90-Revised (Derogatis, 1994; Derogatis, Rickels, & Rock, 1976) is a 90-item measure of mental health symptoms rated