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.     

Puerto Rican Gangs: A Historical Overview

This article presents the problem of gangs on the island of Puerto Rico from a historical, economical, and political perspective. Some Puerto Rican historians are convinced that the gang problem in Puerto Rico is due to the political ambiguity and human rights violations of prison inmates (F. Picò, 1998).     

Puerto Rican youth speaks out: SOME QUOTATIONS

In April 1971 11 lively and perceptive Puerto Rican young people met with guest editor Uvaldo Palomares for a discussion. Nine of the young people were in high school and two were enrolled in universities in the New York City area. All of them were involved in the Aspira Club Federation¹, whose aim is to enlighten and encourage Puerto Rican students to attain the educational level to which they aspire. First Palomares explained to the group that he was preparing a special issue of this journal and would like their opinions about counselors. Then he asked them to respond to the following questions: (a) Are there problems that are special to the Puerto Rican? What do you think is the present situation? (b) What are some positive characteristics of Puerto Ricans that counselors and teachers usually don't know about? (c) Why don't counselors or teachers generally recognize these things? (d) What can they do to overcome this problem? What follows here are frank, forthright responses relating to a great variety of concerns, from culture and stereotyping to poverty and tokenism. The interview has been edited by Geraldine Palomares, who is a consultant at the Human Development Training Institute in San Diego.     

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.     

Syllogistic reasoning in Puerto Rican bilingual elementary school children

The purpose of the present study was to measure the effects of language proficiency and grade (age) on the reasoning of Puerto Rican bilingual children in elementary school. 20 syllogisms were administered, 10 in English and 10 in Spanish, and accuracy of and strategy for solution were examined. Solutions were more often accurate, and the proportion of theoretical explanations given for them was higher in Spanish. Differences by grade were not significant except a higher proportion of theoretical explanations were given by children in Grade 5 for syllogisms in Spanish.     

Acceptability and Cultural Fit of Spiritual Self-Schema Therapy for Puerto Rican Women with Addiction Disorders: Qualitative Findings

We present findings on the (1) acceptability of Spiritual Self-Schema (3-S) therapy with Puerto Rican women and (2) fit with women's cultural, gender, literacy, clinical, and religious backgrounds. 3-S is a well-documented efficacious intervention for substance use and HIV risk behaviors. Participants were 13 urban, low-income Puerto Rican women in a residential treatment program in a large Northeastern city.

Findings from therapy session videotapes, focus groups, and clinician memos indicate high acceptability and fit of 3-S therapy for Puerto Rican women. However, lack of fit in several areas indicates the need for modification of specific aspects of 3-S for Latinas.     

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.     

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.     

Crossing Borders: Multicultural Counseling With Puerto Rican Migrant Women

Puerto Rican migrant women require cultural‐specific counseling. The intersection of ethnicity, gender, culture, and sociopolitical contexts affects Puerto Rican migrant women's psychological coping and identity development. A psychology of place lens is used to discuss how numerous Puerto Rican migrant women nurture their identity development from borderlands (transfronterizas ) to transboricuas (trans–Puerto Rican). A case vignette illustrates the use of a multicultural counseling approach to address Puerto Rican migrant women's psychological needs. Las mujeres puertorriqueñas emigrantes requieren servicios de consejería culturalmente específicos. La intersección de etnicidad, sexo, cultura y contextos sociopolíticos afecta a la capacidad de afrontamiento y el desarrollo de la identidad de las mujeres puertorriqueñas emigrantes. Se usa el enfoque de la psicología de lugar para discutir cómo muchas mujeres puertorriqueñas emigrantes cultivan el desarrollo de su identidad de transfronterizas a transboricuas. Se usa la viñeta de un caso para ilustrar el uso de una aproximación multicultural a la consejería para tratar las necesidades psicológicas de las mujeres puertorriqueñas emigrantes.     

The Ethics of Spiritual Formation for a Christian Puerto Rican in a Postmodern Urban Context

This article examines the ministry-ethical implications and meanings of spiritual formation grounded in the so called ‘culture wars’ and then in light of identity, the postmodern condition and the urban context. It highlights the tensions the church faces between being conformed to the world and being conformed to the image of Jesus (Rom12:2; 8:29, NLT). It offers a critical reflection one some of the lessons that I (the author) have learned over the years and attempts to draw conclusions for Christian education and experience.     

自我概念心理表征的文化神经科学研究

人类自我概念的心理表征在心理学和哲学有深入的研究, 跨文化心理学研究揭示了东西方文化自我概念的结构差异。近年来神经科学借助脑功能成像开始研究自我相关信息加工过程的神经机制, 并探讨是否存在文化特异的自我概念的认知神经表征。跨文化神经成像研究表明自我概念在知觉水平和人格特征表征方面都存在文化差异, 本文综述该领域的研究进展。跨文化和文化启动神经成像研究结果有助于我们理解自我概念表征文化差异背后的神经机制。这些研究推动了文化神经科学的发展。     

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.     

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.     

"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.     

Family Influences on the Long Term Post-Disaster Recovery of Puerto Rican Youth

This study focused on characteristics of the family environment that may mediate the relationship between disaster exposure and the presence of symptoms that met DSM-IV diagnostic criteria for symptom count and duration for an internalizing disorder in children and youth. We also explored how parental history of mental health problems may moderate this mediational model. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children (N?=?1,886 dyads) were interviewed with the Diagnostic Interview Schedule for Children and other questionnaires in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, parents’ relationship quality and parental mental health. SEM models were estimated for parents and children, and by age group. For children (4–10 years old), parenting variables were related to internalizing psychopathology, but did not mediate the exposure-psychopathology relationship. Exposure had a direct relationship to internalizing psychopathology. For youth (11–17 years old), some parenting variables attenuated the relation between exposure and internalizing psychopathology. Family environment factors may play a mediational role in psychopathology post-disaster among youth, compared to an additive role for children. Hurricane exposure had a significant relation to family environment for families without parental history of mental health problems, but no influence for families with a parental history of mental health problems.