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Ethnicity and mental health treatment utilization by patients with personality disorders
Journal of Consulting and Clinical Psychology (2007)
  • Donna S. Bender
  • Andrew E. Skodol
  • Ingrid R. Dyck, Brown University
  • John C. Markowitz
  • M. Tracie Shea, Brown University
  • Shirley Yen, Brown University
  • Charles A. Sanislow
  • Anthony Pinto, Brown University
  • Mary C. Zanarini
  • Thomas H. McGlashan
  • John G. Gunderson
  • Maria T. Daversa
  • Carlos M. Grilo

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic but not White participants, underscoring the importance of special attention to the treatment relationship with minority patients. These treatment use differences raise complex questions about treatment assessment and delivery, cultural biases of the current diagnostic system, and possible variation in PD manifestation across racial/ethnic groups. Future studies need to assess specific barriers to adequate and appropriate treatments for minority individuals with PDs.

  • CLPS,
  • Ethnicity,
  • Treatment Utilization,
  • Mental Health Treatment Utilization,
  • Collaborative Longitudinal Personality Study,
  • Major Depressive Disorder,
  • MDD,
  • Depression,
  • BPD,
  • Borderline Personality Disorder,
  • DSM,
  • DSM-IV,
  • Axis I,
  • Axis II,
  • Personality Disorder Assessment
Publication Date
December, 2007
Citation Information
Bender, D. S., Skodol, A. E., Dyck, I. R., Markowitz, J. C., Shea, M. T., Yen, S., Sanislow, C. A., Pinto, A., Zanarini, M. C., McGlashan, T. H., Gunderson, J. G., Daversa, M. T., & Grilo, C. M. (2007). Ethnicity and mental health treatment utilization by patients with personality disorders. Journal of Consulting and Clinical Psychology, 75(6), 992-999.