A conceptual model of cultural predictors of anxiety among Japanese American and part-Japanese American adolescents

A model integrating Japanese ethnicity, cultural identity, and anxiety was developed and assessed in Japanese American and part-Japanese American high school seniors (N = 141). Using measures from the Hawaiian High Schools Health Survey, the model incorporated the State-Trait Anxiety Inventory, the Major Life Events Scale, and the Japanese Culture Scale (JCS). Japanese American adolescents scored higher on the JCS and reported fewer anxiety symptoms than part-Japanese American adolescents. Predictors for anxiety were being Japanese American versus part-Japanese American, income, and culturally intensified events. A significant interaction of behavior by self-identification was obtained. The model had good overall fit, suggesting that cultural identity formation may contribute to anxiety experienced particularly by adolescents of mixed heritage.     

A confirmatory model for depression among Japanese American and part-Japanese American adolescents

A confirmatory model integrating Japanese ethnicity, cultural identity, and depression was developed (N = 140). The model incorporated the Center for Epidemiologic Studies-Depression Scale (CES-D), Major Life Events Scale, and Japanese Cultural Scale. Japanese American adolescents scored higher on the Japanese Cultural Scale and reported fewer depressive symptoms on the CES-D total and on 2 of the 3 CES-D factors than part-Japanese American adolescents. Predictors for depression were being Japanese American vs. part-Japanese American, female gender, and culturally intensified events. A significant interaction of behavior by self-identification was noted. The model had good overall fit and suggested that the formation of cultural identity may contribute to depressive symptoms experienced by adolescents, particularly adolescents of mixed heritage.     

Psychosis: A Synthesis of Motivational and Defect Perspectives

Based on the evolution of human intelligence and the tremendous cognitive capacities arising from it, we have an innate tendency for the extreme thought content, thought form, and sensory perceptions of psychosis. During the conscious and awake state, cognitive regulatory control processes block these more extreme variants to facilitate reality congruency necessary for adaptive functioning. While asleep there is no need for reality congruency and the cognitive regulatory control processes are deactivated allowing psychotic equivalents to be expressed in dreams. This paper helps synthesize the two dominant perspectives regarding the etiology of psychosis: the neuroscience defect perspective and the psychoanalytic motivational perspective. Regarding the former, defective cognitive regulation arising from certain conditions, such as the deficit state of schizophrenia, allows extreme cognitive distortions, thought form variants, and sensory perceptual experiences to intrude into the conscious and awake state, thereby producing psychosis. Consistent with the psychoanalytic motivational perspective, defensive processes can motivate extreme cognitive distortions, thought form variants and sensory perceptual experiences, and also facilitate their expression by deactivating the relevant cognitive regulatory control processes.     

Potential causal relationship between depressive symptoms and academic achievement in the Hawaiian high schools health survey using contemporary longitudinal latent variable change models

There is a relatively consistent negative relationship between adolescent depressive symptoms and educational achievement (e.g., grade point average [GPA]). However, the causal direction for this association is less certain due to the lack of longitudinal data with both indicators measured across at least 2 time periods and due to the lack of application of more sophisticated contemporary statistical techniques. We present multivariate results from a large longitudinal cohort-sequential study of high school students (N = 7,317) with measures of self-reported depressive symptoms and self-reported GPAs across multiple time points (following McArdle, 2009, and McArdle, Johnson, Hishinuma, Miyamoto, & Andrade, 2001) using an ethnically diverse sample from Hawai'i. Contemporary statistical techniques included bivariate dynamic structural equation modeling (DSEM), multigroup ethnic and gender DSEMs, ordinal scale measurement of key outcomes, and imputation for incomplete longitudinal data. The findings suggest that depressive symptoms affect subsequent academic achievement and not the other way around, especially for Native Hawaiians compared with female non-Hawaiians. We further discuss the scientific, applied, and methodological-statistical implications of the results, including the need for further theorizing and research on mediating variables. We also discuss the need for increased prevention, early intervention, screening, identification, and treatment of depressive symptoms and disorders. Finally, we argue for utilization of more contemporary methodological-statistical techniques, especially when violating parametric test assumptions.     

Measuring Productivity in Primary Care Behavioral Health: A Delphi Study

High productivity by behavioral health consultants (BHC) is a defining aspect of the primary care behavioral health (PCBH) model to maximize access to care and is often measured by patient volume. Studies of productivity in health care settings suggest a single productivity target may not be optimal. We used a Delphi method to obtain expert consensus on an operational definition of high productivity by BHCs in the PCBH model. Clinicians, managers, and researchers in PCBH were recruited to participate in a multi-round survey using a modified Delphi technique and develop consensus on PCBH productivity metrics. Ten participants completed all three survey rounds and rated 28 metrics. After three rounds, two direct metrics (average number of billable BHC visits each day; number of patients seen per day) received at least 80% consensus as “Essential”, two received at least 50%, and five received less than 50%. One influencer (level of integration at the practice) received at least 80% consensus as “Very Much” influential, 19 received at least 50%, and eight items received less than 50%. Several themes arose from participant comments. PCBH productivity can be interpreted as being high volume. Numerous practice factors influence how productive a BHC may be. Future studies should determine the feasibility of our metrics in clinical practice, establish productivity expectations based on patient needs and clinic resources, and identify patient-, clinician-, or practice-level moderators of productivity.

     

The animacy advantage for free-recall performance is not attributable to greater mental arousal

People often demonstrate better memory for animate concepts (e.g., lion and sailor) than for inanimate concepts (e.g., hammer and mountain). Researchers have attributed this effect to an adaptive memory mechanism that favours information relevant for survival, including information about living things. In the present experiment, we examined the hypothesis that people demonstrate better free-recall performance for animate than inanimate words because animate words tend to be associated with greater mental arousal than inanimate words, a factor that was not controlled for in previous experiments on this topic. To this end, we matched animate and inanimate word lists on mental arousal (and several other factors), and compared participants’ free-recall performance for the two word types. We were able to replicate past findings that participants’ free-recall of animate words exceeds their free-recall of inanimate words, but we found no support for the possibility that the effect stems from differences in mental arousal between animate and inanimate concepts, as this effect maintained even when the word lists were matched on mental arousal. The present results therefore indicate that mental arousal cannot explain the effects of animacy on free-recall performance.