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Objective-Although widely reported among Latinos, contradictory evidence exists regarding the generalizability of the immigrant paradox; that foreign nativity is protective against psychiatric disorders. We examine whether this paradox applies to all Latino groups by contrasting estimates of lifetime psychiatric disorders among Latino immigrants, Latino U.S-born, and non-Latino whites.Method-Data from the National Latino and Asian American Study and the National Comorbidity Survey Replication represent some of the largest nationally-representative samples with psychiatric information.Results-In aggregate, Latinos are at lower risk of most psychiatric disorders compared to nonLatinos whites and, consistent with the immigrant paradox, U.S.-born Latinos report higher rates for most psychiatric disorders than Latino immigrants. However, rates vary when data are stratified by nativity and disorder and adjusted by demographic and socioeconomic differences across groups. Among Mexicans, the immigrant paradox consistently holds across mood, anxiety and substance disorders while it is only evident among Cubans and Other Latinos for substance disorders. No differences were found in lifetime prevalence rates between migrant and U.S.-born Puerto Ricans.Conclusions-Caution should be exercised in generalizing the immigrant paradox to all Latinos and for all psychiatric disorders. Aggregating Latinos into a single group masks great variability in lifetime risk for psychiatric disorders, with some subgroups, like Puerto Ricans, suffering from psychiatric disorders at rates comparable to non-Latino whites. Our findings thus suggest that the protective context in which immigrants lived in their country of origin possibly inoculated them against risk for substance disorders, particularly if they immigrated as adults.

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This paper provides a rationale and overview of procedures used to develop the National Latino and Asian American Study (NLAAS). The NLAAS is nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service utilization of Latinos and Asian Americans in the United States. The central aims of the NLAAS are to: 1) describe the lifetime and 12-month prevalence of psychiatric disorders and the rates of mental health services use for Latino and Asian American populations using nationwide representative samples of Latinos and Asian Americans, 2) assess the associations among social position, environmental context, and psychosocial factors with the prevalence of psychiatric disorders and utilization rates of mental health services, and 3) compare the lifetime and 12-month prevalence of psychiatric disorders, and utilization of mental health services of Latinos and Asian Americans with national representative samples of non-Latino whites (from the National Comorbidity Study-Replication;

Our results provide important information about potential correlates of psychiatric problems among Latinos that can inform clinical practice and guide program development. Stressors associated with cultural transmutation may exert particular pressure on Latino men. Continued attention to environmental influences, especially among third-generation Latinos, is an important area for substance abuse program development.