Long Term Outcomes to Family Caregiver Empowerment

The Vanderbilt Caregiver Empowerment Project evaluated a training program designed to enhance empowerment of caregiver and their subsequent involvement in the mental health treatment of their children. The intervention utilized a multi-component parent training curriculum that was designed to enhance: (a) knowledge of the service system; (b) skills needed to interact with the mental health system; and (c) the caregiver' s mental health services self-efficacy designed to improve caregivers beliefs in their ability to collaborate with service providers. The resulting increased empowerment was hypothesized to increase caretaker involvement, which should affect service use and ultimately the mental health status of the child. A randomized design was used to test the effectiveness of this model with caregivers of children receiving mental health services. The results one-year after the training replicated the intermediate outcomes of the project conducted 3-months after the training. The initial training continued to significantly influence the parent's knowledge and mental health services self-efficacy. However, the intervention had no effect on caregiver involvement in treatment, service use or the mental health status of the children.     

"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.     

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.     

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.     

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.     

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.     

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.     

Mediational models of spirituality and depressive symptomatology among HIV-positive Puerto Rican women

A survey of 142 Puerto Rican women living with HIV/AIDS in New York City revealed high Centers for Epidemiological Studies Depression (CES-D) scores, with 66% of the sample scoring above the conventional threshold of possible clinical depression. Most respondents (71%) were Catholic, 29% considered themselves members of a church or other place of worship, and 30% reported attending religious services 1-3 times a month. As predicted, spirituality was high and negatively associated with CES-D scores. A series of simultaneous multiple regression analyses controlling for all potentially confounding medical and sociodemographic variables demonstrated that both mastery and self-esteem scores mediated this relationship. Implications for future research and the provision of services to HIV-positive Puerto Rican women are discussed.     

Doctors Who Integrate Spirituality and CAM in the Clinic: The Puerto Rican Case

This article describes Puerto Rican physicians’ personal and clinical utilization of complementary and alternative medicines (CAM), its effects, and use as they identified as either Spiritist, spiritual or religious. Semi-structured interviews were conducted with 74 doctors in Puerto Rico. Major themes and relationships among them were charted using the qualitative data analysis program MAXQDA, open coding and grounded theory. Thirty-one doctors spoke of CAM and its use as related to their spiritual or religious perspectives. Spiritual or Spiritist doctors were more inclined than religious doctors to utilize CAM. Seeking closer relationships with patients was related to a spiritually oriented goal of healing (as distinct from curing) as a reason to recommend CAM.     

Adaptation of parent-child interaction therapy for Puerto Rican families: a preliminary study

This study examines how parent-child interaction therapy (PCIT) was adapted for Puerto Rican parents of children aged 4-6 with hyperactivity and other significant behavior problems. Four steps were followed: (1) translation and preliminary adaptation of the treatment manual, (2) application of the treatment to 9 families as part of an exploratory study using repeated measures, (3) treatment revision and refinement, and (4) in-depth interviews with parents (n=15) and clinical psychologists (n=5) from Puerto Rico who provided feedback on treatment process and components. Throughout this process, cultural elements and modifications were recommended to be incorporated into the treatment protocol. Both quantitative and qualitative results suggest that PCIT seems to be an acceptable intervention for this population, with some minor changes. Parents reported a high level of satisfaction, a significant reduction in children's externalizing behavior problems, and reduction of parenting stress and improvement in their parenting practices. Psychologists also evaluated positively the treatment protocol and recommended its use. Results from this study may inform clinicians and researchers who work with Latino families about relevant issues to be considered to promote their participation in behavioral family interventions and to enhance their acceptability and effectiveness.     

Using Open-Ended Interviews to Determine Why Puerto Rican Students Drop Out of School

Latino youth account for 10% of all elementary and secondary school students and are among the most undereducated in the United States (Perez, 1993). Many low socioeconomic status (SES) Latino youths are dropping out of high school. There are few contemporary studies on this dilemma. Based on students' opinions and perceptions, this article examines why one subgroup of the Latino population, Puerto Ricans, is not graduating from high school.     

A framework for studying minority youths' transitions to fatherhood: the case of Puerto Rican adolescents

A theoretical framework is proposed for studying minority young men's involvement with their babies that combines the integrative model of minority youth development and a life course developmental perspective with Lamb's revised four-factor model of father involvement. This framework posits a relationship between demographic and family background variables (such as education, employment, income, and family of origin) and fatherhood outcomes moderated by personal characteristics (such as sex-role ideology, acculturation, risk taking, and alienation) and mediated by definitions of fatherhood, life priorities normative for the culture under study, and sexual behavior. Once there is an acknowledged infant, a father's involvement is influenced by child characteristics, perceived fathering competence, social support, and quality of the relationship with the mother.     

Asthma in children of Caribbean descent living in the inner-city: comparing Puerto Rican and Afro-Caribbean children

Ethnic minority children bear a disproportionate amount of the US asthma burden. We compared asthma morbidity and pulmonary function (%FEV₁) in two Caribbean groups living in the Bronx, NY: Puerto Rican and Afro-Caribbean children. Caregiver-child dyads (Puerto Rican: n = 113, M age = 9.89 ± 2.05; Afro-Caribbean: n = 47, Mage = 10.35 ± 2.08) responded to sociodemographic and asthma-related questions, and children’s %FEV₁ was measured. Puerto Rican children had significantly greater (past year) asthma morbidity, yet there were no significant differences in %FEV₁. This discrepancy between objective pulmonary function and asthma morbidity suggests the importance of considering sociocultural factors in pediatric asthma care.