Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety

Dawson DB, Tsao CG, Chen PV, Giardina T, Fletcher TL. Providers' perspectives on the impact of culture in the recognition and diagnosis of anxiety. Journal of Mood & Anxiety Disorders. 2023 Dec 1; 4:https://doi.org/10.1016/j.xjmad.2023.100030.

Related HSR&D Project(s)

• IIR 17-241 – Anxiety diagnostic accuracy in VA primary care mental health integration settings: Identifying barriers and facilitators to inform a learning health care system

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Abstract:

Objectives We examined providers' perspectives about how culture affects diagnosing and recognizing anxiety. Methods We interviewed providers about diagnosing anxiety ("How do you think culture impacts expression and diagnosis of anxiety?") and used inductive analysis, with open coding, to allow themes to emerge organically. Results We identified three themes: (1) Impartiality toward Culture: downplaying culture in recognizing or diagnosing anxiety and not acknowledging necessary cultural diagnostic considerations; (2) Acknowledgment of Cultural Impact: detailed variations across different cultural communities in how patients present with and describe anxiety, with differing levels of stigma associated with expressing and treating anxiety; (3) Culturally Integrated Practice: implement culturally informed diagnosis and treatment, with training and self-directed processing on culture and bias. Conclusions While most providers acknowledge that culture impacts accurate diagnosis of anxiety, they vary in how they integrate cultural information. It is important to deliver culturally informed care.