Three studies are currently planned or underway, all involving investigation of mental health and illness in Mexican Americans. The first is an Epidemiological Catchment Area study just approved and funded with Dr. Hough as principal investigator. Dr. Karno is listed as 25% time on this project. This proposal, with which he was substantially involved, includes interviews with 3000 non-institutionally resident Mexican-American and Anglo-American adults in two Los Angeles catchment areas. The interview is based on the Diagnostic Interview Schedule developed by Dr. Lee Robins and translated into Spanish by Dr. Karno this past year. The interviews are to be repeated after 1 year. Further, two sets of interviews of 500 institutionally resident Mexican-American and Anglo-American adults from the same catchment areas will be carried out, also 1 year apart. In addition to providing information on the incidence and prevalence of DSM diagnoses, the interview and follow-up will obtain information on service utilization, life stress, coping, stigma, and social support. The second study is directed by Dr. Karno as principal investigator. This investigation of the course of schizophrenia among Mexican-Americans was originally submitted for a full study but was funded as a pilot study with an encouragement for resubmission. It includes the one year follow-up of Mexican-American schizophrenics following hospital discharge. The measures included in the several interviews and test procedures are the Camberwell Family Instrument (which Dr. Karno has translated into Spanish) which taps the """"""""expressed emotionality"""""""" dimension, two TAT derived measures of communication and affective style for family members, CPT and SPAN testing for patients, and an intensive anthropological investigtion of the family (by Dr. John Kennedy, an anthropologist colleague). Medication, treatment, interpersonal contact, and illness status are to be assessed at each point. The Present State Examination has been translated for this study. The purposes of the study, now in its pilot phase are """"""""to determine 1) whether or not there are factors of intra-familial structure, behaviors and communication which culturally distinguish traditional Mexican-American families from Anglo-American and British families, and which provide distinctive tolerance for and/or protection against relapse of psychotic symptomatology among schizophrenic family members; 2) provide data on the validity of the assumption that attentional measures are culture-free indicators of underlying schizophrenic dysfunction; and 3) document by detailed anthropoligcal life history interviewing, the phenomenology and career experience of a small number of Mexican-American patients and their families."""""""" The third study is a recently funded investigation of the social networks of Hispanic schizophrenics on which J. Escobar, M.D. is principal investigator and Dr. Karno is a consultant. This study is based on a Veterans' Administration sample of discharged Anglo-American and Hispanic-American schizophrenics, and assesses acculturation and social and personal histories as well as the structure and function of social networks as related to change in psychopathology over a two-year follow-up period.
