© 2008 American Psychological Association. Published by Blackwell Publishing on behalf of the American Psychological Association. All rights reserved. For permissions, please email: journalsrights@oxon.blackwellpublishing.com 35 Blackwell Publishing Inc Malden, USA CPSP Clinical Psychology: Science and Practice 0969-5893 © 2008 American Psychological Association. Published by Blackwell Publishing on behalf of the American Psychological Association. All right reserved. For permission, please email: journalsrights@oxon.blackwellpublishing.com XXX Original Articles PTSD IN ETHNORACIAL MINORITIES • POLE ET AL. CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE • V15 N1, MARCH 2008 Posttraumatic Stress Disorder Among Ethnoracial Minorities in the United States Nnamdi Pole, Joseph P. Gone, and Madhur Kulkarni, Department of Psychology, The University of Michigan Because ethnoracial minorities are a growing part of the U.S. population yet are underrepresented in the psychopathology literature, we reviewed the evidence for differences in prevalence and treatment of post- traumatic stress disorder (PTSD) in African Americans, Latino Americans, Asian and Pacific Islander Americans, and American Indians. With respect to prevalence, Latinos were most consistently found to have higher PTSD rates than their European American counterparts. Other groups also showed differences that were mostly explained by differences in trauma exposure. Many prevalence rates were varied by subgroup within the larger ethnoracial group, thereby limiting broad genera- lizations about group differences. Regarding service utili- zation, some studies of veterans found lower utilization among some minority groups, but community-based epidemiological studies following a traumatic event found no differences. Finally, in terms of treatment, the literature contained many recommendations for culturally sensitive interventions but little empirical evidence supporting or refuting such treatments. Taken together, the literature hints at many important sources of ethnoracial variation but raises more questions than it has answered. The article ends with recommendations to advance work in this important area. Key words: African Americans, American Indians, Asian Americans, Latino Americans, minority mental health, Pacific Islanders, PTSD. [Clin Psychol Sci Prac 15: 35–61, 2008] Clinical psychologists have been urged to pay greater attention to ethnoracial 1 variation in psychopathology by their own ethical and professional codes (American Psychological Association, 2002, 2003), the National Institutes of Health (2001), and even the Surgeon General of the United States (U.S. Department of Health and Human Services, 2001). Unfortunately, information on minority mental health is often difficult to find in mainstream psychology journals. In this review, we focus on posttraumatic stress disorder (PTSD) as it occurs in each of the four primary ethnic minority groups in the United States: African (Black) Americans, Latino (Hispanic) Americans, Asian and Pacific Islander Americans, and (Native)AmericanIndians, 2 who together constitute over 30% of the U.S. population. We begin with a sociodemographic sketch of each group to provide a context from which to understand PTSD- related group differences and to show that each group is actually an aggregation of subgroups that may themselve have unique vulnerabilities to PTSD. After briefly reviewing comparative rates of other mental disorders we will compare PTSD rates in each ethnic minority group to PTSD rates in European (Caucasian/White) American samples. We will do so in both epidemiological and clinical samples recognizing that whereas the former may be informative about the general population, the latter may be informative about clinical settings. We Address correspondence to Nnamdi Pole, Department of Psychology, 530 Church Street, 2260 East Hall, Ann Arbor, MI 48109-1043. E-mail: nnamdi@umich.edu.