"But you don't look Puerto Rican": the moderating effect of ethnic identity on the relation between skin color and self-esteem among Puerto Rican women

This exploratory study investigated whether ethnic identity, as assessed by Phinney's (1992) Multigroup Ethnic Identity Measure, functioned as a moderator in the relation between skin color (as measured by masked interviewer evaluation, participant self-report, and skin reflectance data) and self-esteem (as measured by Rosenberg's 1989 Self-Esteem Scale). In a sample of 53 English-speaking Puerto Rican women, a hierarchical multiple regression indicated that among lighter skinned women, those who felt less attached to their culture had less self-esteem than those who were more culturally embedded. Similarly, among darker skinned women, greater attachment to Puerto Rican culture was associated with greater self-esteem than a less defined ethnic identity. Findings are discussed in light of the beneficial effects of ethnic identity.     

Individual and group CBT and IPT for Puerto Rican adolescents with depressive symptoms

This study compared individual (I) to group (G) formats of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for the treatment of depression in adolescents. One hundred and 12 Puerto Rican adolescents were randomized to four conditions (CBT-I, CBT-G, IPT-I, IPT-G). Participants were assessed at pretreatment and posttreatment with structured interviews to establish diagnosis and with self-report measures to assess treatment outcome. The results suggest that CBT and IPT are robust treatments in both group and individual formats. However, CBT produced significantly greater decreases in depressive symptoms and improved self-concept than IPT. The implications of these findings are discussed.     

A randomized controlled trial of a peer support intervention targeting antiretroviral medication adherence and depressive symptomatology in HIV-positive men and women.

OBJECTIVE: To determine the efficacy of a peer-led social support intervention involving support groups and telephone contacts compared with standard clinical care to enhance antiretroviral medication adherence. DESIGN: Randomized controlled trial with follow-up. Participants were 136 HIV-positive indigent mainly African American and Puerto Rican men and women recruited from an outpatient clinic in the Bronx, New York. The 3-month intervention was delivered by other HIV-positive clinic patients trained in addressing barriers to adherence and sensitively providing appraisal, spiritual, emotional, and informational adherence-related social support. MAIN OUTCOME MEASURES: Medical chart-abstracted HIV-1 RNA viral load, antiretroviral adherence according to electronic drug monitoring and participant self-report, and social support and depressive symptomatology. All assessments conducted at baseline, 3 months, and 6 months. RESULTS: Intent-to-treat and as-treated analyses indicated no between-conditions intervention effects on the primary outcome of HIV-1 RNA viral load or any of the secondary outcomes at immediate postintervention or follow-up. Post hoc analyses within the intervention condition indicated greater intervention exposure was associated with higher self-reported adherence, higher social support, and lower depressive symptomatology at follow-up, even after controlling for baseline adherence. CONCLUSION: Null findings, consistent with the limited literature on efficacious highly active antiretroviral therapy (HAART) adherence interventions, may be due to insufficient exposure to the intervention, its low intensity, or the nature of the sample-a heterogeneous HAART-experienced group of patients with high levels of substance use and multiple other competing stressors. Overall, findings highlight the need for more comprehensive and intensive efforts to battle nonadherence.     

Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

Sex-role orientation and depressive symptomatology

Sex Roles - The incidence of depressive disorders among women in our society is considerably higher than it is for men. Several investigators have suggested that this is due to traditional sex...     

Discrimination and Puerto Rican children's and adolescents' mental health

Two studies of Puerto Rican youths' development on the U.S. mainland examined the consequences of perceived racial/ethnic discrimination on mental health. In Study I, children were found to have a low likelihood of perceiving discrimination, whereas in Study 2, nearly half of the adolescent sample reported perceiving racial/ethnic discrimination. Although both groups scored high on multiple indicators of mental health, perceiving discrimination and worrying about discrimination were negatively associated with some dimensions of self-esteem and positively associated with depression and stress. Adolescents were aware of negative stereotypes about Puerto Ricans, and nearly half of them related discriminatory instances. Results suggest that both perceiving discrimination and anxiety regarding discrimination can serve as risk factors for the mental health of this population.     

Linkages between depressive symptomatology and Internet harassment among young regular Internet users.

Recent reports indicate 97% of youth are connected to the Internet. As more young people have access to online communication, it is integrally important to identify youth who may be more vulnerable to negative experiences. Based upon accounts of traditional bullying, youth with depressive symptomatology may be especially likely to be the target of Internet harassment. The current investigation will examine the cross-sectional relationship between depressive symptomatology and Internet harassment, as well as underlying factors that may help explain the observed association. Youth between the ages of 10 and 17 (N = 1,501) participated in a telephone survey about their Internet behaviors and experiences. Subjects were required to have used the Internet at least six times in the previous 6 months to ensure a minimum level of exposure. The caregiver self-identified as most knowledgeable about the young person's Internet behaviors was also interviewed. The odds of reporting an Internet harassment experience in the previous year were more than three times higher (OR: 3.38, CI: 1.78, 6.45) for youth who reported major depressive symptomatology compared to mild/absent symptomatology. When female and male respondents were assessed separately, the adjusted odds of reporting Internet harassment for males who also reported DSM IV symptoms of major depression were more than three times greater (OR: 3.64, CI: 1.16, 11.39) than for males who indicated mild or no symptoms of depression. No significant association was observed among otherwise similar females. Instead, the association was largely explained by differences in Internet usage characteristics and other psychosocial challenges. Internet harassment is an important public mental health issue affecting youth today. Among young, regular Internet users, those who report DSM IV-like depressive symptomatology are significantly more likely to also report being the target of Internet harassment. Future studies should focus on establishing the temporality of events, that is, whether young people report depressive symptoms in response to the negative Internet experience, or whether symptomatology confers risks for later negative online incidents. Based on these cross-sectional results, gender differences in the odds of reporting an unwanted Internet experience are suggested, and deserve special attention in future studies.     

Correlates of aggression in African American and Puerto Rican children

The authors examined a cross-sectional interrelationship of psychosocial domains as they relate to aggression in a group of African American and English-speaking Puerto Rican children living in New York City. The population included 80 biological children of African American and Puerto Rican young adults who had been participating in the authors' ongoing longitudinal study, and 77 mothers or mother substitutes (rearing mothers) of those children. The authors performed hierarchical multiple regression analysis. The results indicated that (a) the child's personality and maternal attributes were significantly related to the child's aggression, despite control on all of the other domains and (b) the ethnic identification and discrimination domain was no longer related to the child's aggression with control on the mother-child relationship domain or on the child's personality domain. The findings have implications for clinical practice and public policy.     

Natural Disaster and Risk of Psychiatric Disorders in Puerto Rican Children

We examined the persistence of psychiatric disorders at approximately 18 and 30 months after a hurricane among a random sample of the child and adolescent population (4–17 years) of Puerto Rico. Data were obtained from caretaker-child dyads (N = 1,886) through in person interviews with primary caretakers (all children) and youth (11–17 years) using the Diagnostic Interview Schedule for Children IV in Spanish. Logistic regressions, controlling for sociodemographic variables, were used to study the relation between disaster exposure and internalizing, externalizing, or any disorder. Children’s disaster-related distress manifested as internalizing disorders, rather than as externalizing disorders at 18 months post-disaster. At 30 months, there was no longer a significant difference in rates of disorder between hurricane-exposed and non-exposed youth. Results were similar across age ranges. Rates of specific internalizing disorders between exposed and unexposed children are provided. Research and clinical implications are discussed.     

Archetypes and Spirits: A Jungian Analysis of Puerto Rican Espiritismo

In this paper a comparison is made between Jung's approach to healing with a traditional healing system practised in Puerto Rico, called ‘Espiritismo’. Jungian psychology and ‘Espiritismo’ have several strong similarities in their conception of the therapeutic process, similarities which suggest that the healing process itself has generic properties which can be found in several therapeutic systems. In addition, by analysing Jung's development as a healer, it is possible to draw parallels between his development as a psychotherapist and the process of becoming a spiritist healer. In both healing systems, a transpersonal dimension is recognized as an integral element in the healing process. In ‘Espiritismo’, the suffering individual has to confront the spirit world; in analytical psychotherapy the patient has to confront the collective unconscious. This parallel was explicitly recognized by Jung in his autobiography when he compared the collective unconscious with the land of the dead. For Jung, knowledge of the figures of the unconscious enormously facilitates the individuation process; in ‘Espiritismo’ it is necessary to know the spirit world and to establish a relationship with the spirits. In Jungian psychology, healing is a process of ‘exorcizing’ some types of complexes or integrating others to consciousness. On the other hand, spiritist healers ‘exorcize’ ignorant spirits in order to heal a client or help him/her to identify spirit guides. In both systems, healing is essentially a process of establishing a dialogue with a transpersonal dimension (archetypes or spirits). Healing in ‘Espiritismo’ and Jungian psychology is a process of transcending the limited perspective of the ego (the ‘material world’) in order to experience a much broader reality (spiritual world or collective unconscious). Both systems emphasize the need to work with resources beyond the boundaries of the ego and to connect with forces that belong to a different reality.     

An examination of the relationships among emotion management,interpersonal hassles,and depressive symptomatology

This study extended previous research by testing three models predicting depressive symptoms from emotion management (EM) and interpersonal hassles in a sample with a wide range of depression scores. Adults (n = 218) from sources including a depression internet site completed measures of interpersonal hassles, depression, and three aspects of EM (attention to, clarity of, and repair of emotions). Regression analyses supported a model in which lower clarity and repair scores and greater frequency of interpersonal hassles each contributed directly to depression scores. While lower attention to emotions was associated with fewer interpersonal hassles, it did not correlate significantly with depression scores. Moderation analyses did not support a model of EM components acting on depression by buffering effects of interpersonal hassles. A model of depression and hassles predicting EM difficulties was also considered; when both hassles and depression scores were entered to predict EM, only depressive symptoms uniquely predicted clarity and repair.     

Sequences of drug involvement in African-American and Puerto Rican adolescents.

This study examined stages in drug involvement of 695 African-American and 637 Puerto Rican adolescents. Analysis indicated that adolescents progress through several stages of drug involvement: beer/wine, cigarettes or hard liquor, then marijuana, and, finally, illicit drugs other than marijuana. The sequence of drug involvement for both ethnic groups appears to be both unidimensional and cumulative.     

Reliability of children's reports of depressive symptomatology

The use of self-report measures for the assessment of depression in children has gained wide popularity as a component in the evaluation of children's mental health and wellbeing. However, the extent to which children are reliable and consistent reporters of their depressive symptoms is sometimes called into question. This study examined the test-retest reliability of children's reports of depressive symptomatology on the Reynolds Child Depression Scale (RCDS;Reynolds, 1989a). The sample consisted of 220 children, in grades 3 through 6, representing a crosssection of ethnic groups. Children were tested twice, with a 4-week interval between testings. Results showed a high degree of stability in children's responses to the RCDS, with a test-retest reliability coefficient of 85 for the total sample, and a mean difference between testings of less than 2 points. Test-retest reliability coefficients were also computed for males and females, for each grade, and for white, black, Hispanic, and Asian children. Overall, the results lend strong support for the reliability and stability of children's self-reported depressive symptomatology as assessed by the RCDS.The authors wish to express their appreciation to Dr. Eleanor Chiang and Rovida Mott of the Sacramento Public Schools for their assistance in obtaining school and subject participation.     

Stress, psychosocial resources, and depressive symptomatology during pregnancy in low-income, inner-city women.

The authors examined the prospective influence of stress, self-esteem, and social support on the postpartum depressive symptoms of 191 inner-city women (139 European Americans and 52 African Americans) over 3 waves of data collection. Depressive symptomatology was measured by multiple indicators, including self-report and clinical scales. Women became less depressed as they move from prenatal to postpartum stages and adjusted to their pregnancy and its consequences. LISREL and regression analyses indicated that stress was related to increased depression, whereas greater income and social support were related to decreased depression. Self-esteem was related to lower depression at the prenatal and postpartum periods but not to change in depression from the prenatal to the postpartum period. The results also indicated that self-esteem and social support did not have additional stress-buffering effects over and above their direct effects on depression. Finally, African American women did not differ from European American women terms of depression or in terms of how they were impacted by stress or psychosocial resources.     

Illicit drug use and risky sexual behavior among African American and Puerto Rican urban adolescents: the longitudinal links

The authors assessed whether (a) early illicit drug use predicted later risky sexual activity, (b) early risky sex predicted later illicit drug use, and (c) common factors affected both risky sexual behavior and illicit drug use. African American and Puerto Rican youth completed questionnaires in their classrooms at Time 1 (T1) and face-to-face interviews with the authors in their homes 5 years later at Time 2 (T2). Logistic regression analyses showed the association between T1 illicit drug use and T2 risky sexual activity and between T1 risky sexual behavior and T2 illicit drug use. With few exceptions, T1 illicit drug use was associated with all of the T2 risky sexual behaviors. After controlling for demographic factors, the authors found that multiple sex partners at T1 was not related to illicit drug use at T2. Condom use at T1 was related to illicit drug use at T2, whereas sexually transmitted diseases and adolescent pregnancy were not related to this drug use. The findings indicated that assessments of and treatments for substance use should focus on the risky sexual behaviors that seem to accompany illicit drug use.     

Support Networks of Single Puerto Rican Mothers of Children with Disabilities

The social support networks of 25 Puerto Rican single mothers of young children with disabilities were examined and compared with current models of family support for children with disabilities. This study was designed to assess the support systems of Latino single mothers in light of dominant models of family support. The Family Support Scale, the ECOMAP, and responses to open-ended questions were employed to describe the characteristics of Puerto Rican single mothers’ support systems. Study findings suggest that members of the children’s immediate and extended kinship system, including non-blood relatives (e.g., madrinas), play a strong role in the support network of the mothers interviewed. Implications for early childhood professionals who work with Latino parents of children with disabilities are examined.