Psychiatric and Demographic Predictors of Memory Deficits in African Americans with Schizophrenia: The Moderating Role of Cultural Mistrust

Although African Americans are overrepresented among schizophrenia diagnoses, assessments of memory deficits in schizophrenia
often do not consider issues of race, ethnicity, and culture. Digit span testing (DST) is often used to assess memory problems
associated with schizophrenia. The purpose of the current study was to examine the effects of psychiatric symptoms and demographic
background on the DST performances of 128 African American schizophrenic patients. It was hypothesized that level of cultural
mistrust would moderate the relationship of psychiatric and demographic variables to memory deficits. The study involved the
secondary analysis of data from the Culturally-Sensitive Diagnostic Interview Research Project. Different models of the relationship
among predictor variables in their impact on DST performance were tested via structural equation modeling (SEM); and the moderating
effects of level of cultural mistrust were evaluated with the best SEM model. The results supported the hypothesis that level
of cultural mistrust moderates the relationship among variables in the SEM model. Specifically, psychiatric symptoms negatively
impacted DST performance in the low cultural mistrust group, but they had no significant association to the memory deficits
of the high cultural mistrust group. The pattern of findings for the effects of psychiatric symptoms on DST performance is
consistent with the view of cultural mistrust as an adaptive mechanism in African Americans. One implication is that cultural
factors should be taken into account when assessing memory deficits in African Americans with schizophrenia.