A Mixed Methods Approach to Transdiagnostic Measurement of Psychological Distress among Latinx and African Newcomer Populations in the United States

Objectives: This study addresses limitations in standardized mental health measures for assessing psychological distress among Latinx and African newcomers in the United States. Methods: Using a longitudinal mixed methods design, we collected quantitative data from 1,188 participants across seven timepoints and qualitative interviews with a subsample of 36 participants during the COVID-19 pandemic. Initial analyses of NIMH-required instruments (PHQ-9, GAD-7, DSM-V Cross-Cutting Symptom Measure) revealed unexpectedly low distress scores, contrasting with qualitative narratives describing significant suffering. Through integrated analysis, we identified discrepancies between symptom endorsement and lived experiences, highlighting cultural and contextual factors influencing distress expression. Guided by transdiagnostic frameworks, we developed the Integrated Distress Score (IDS) by combining items from depression, anxiety, stress, and coping measures. Results: Confirmatory factor analyses supported a second-order model with strong fit indices (RMSEA = 0.046; CFI = 0.981; TLI = 0.979). External validity was demonstrated through associations with discrimination, social support, and economic insecurity. IDS scores differentiated subgroups qualitatively categorized as “Hidden Stressed and Distressed” versus “Stressed but not Distressed,” capturing heterogeneity in distress and resilience. Conclusions: Findings underscore the insufficiency of universal symptom-based tools for newcomer populations and advocate for culturally responsive, transdiagnostic approaches that integrate qualitative insights. This work contributes a pragmatic measure for evaluating intervention outcomes and offers conceptual implications for moving beyond categorical diagnoses toward dimensional, context-sensitive models of mental health. Future research should refine and validate IDS across diverse newcomer groups and sociocultural settings.