African Americans and anxiety disorders research: Development of a testable theoretical framework

The past decade has witnessed a tremendous growth in the population of minorities in this country. As this segment of the population has grown, psychology has slowly begun to realize the need to examine the presentation of psychological symptoms among minorities as well as the response of minorities to traditional psychological treatment. While several investigations have been conducted to date, the results are far from consistent. Some studies have demonstrated marked differences in the symptom profiles and treatment responses of minorities as compared with Whites, while others have found little, if any, differences. A major contributing factor to such inconsistent results may be that research in this area has typically proceeded in the absence of a testable theoretical framework. This review examines research conducted with a specific minority population, African Americans, suffering with a DSM anxiety disorder. We first examine the epidemiological and treatment outcome studies in an effort to ascertain the consistencies and inconsistencies that exist within the literature. More importantly, we then provide a preliminary theoretical framework that not only accounts for the discrepant findings, but also allows investigators to generate testable hypotheses regarding the manifestation and presentation of anxious symptoms, and to evaluate the efficacy of psychological interventions among African Americans. We conclude with suggestions for future investigations in this area.