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Depression and suicidality in Latino adolescents: A study of acculturation and gender role beliefs

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Depression and suicidality in Latino adolescents: A study of acculturation and gender role beliefs

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Content DEPRESSION AND SUICIDALITY IN LATINO ADOLESCENTS: A STUDY OF ACCULTURATION AND GENDER ROLE BELIEFS Copyright 2004 by Yolanda M. Cespedes A Thesis Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTER OF ARTS (PSYCHOLOGY) August 2004 Yolanda M. Cespedes Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 1422386 INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleed-through, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. ® UMI UMI Microform 1422386 Copyright 2004 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS List of Tables and Figures iii Abstract iv Specific Aims 1 Background and Significance 3 Experimental Design and Methods 16 Data Analysis 25 Results 26 Discussion 34 References 40 ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LIST OF TABLES AND FIGURES Table 1: Independent Sample Statistics: Male and Female Scores on Depression and Gender Role Beliefs Measures Table 2: Correlations Between Discrepancy Variables, Family Cohesion, Family Conflict, Depressive Affect, and Suicidality Table 3: Results of Hierarchical Regressions Testing for Gender as Moderator of the Machismo Discrepancy and Depression Association Figure 1: Machismo Discrepancy and Gender Interaction Effect on TeenScreen Depression Table 4: Results of Hierarchical Regressions Testing for Family Cohesion As Mediator of the AWS Discrepancy and Depression Association Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT The adolescent population frequently experiences depression and engages in suicidal behavior. Adolescent Latinos, especially females, are at increased risk for depression and suicidality compared to their Anglo-American and African-American counterparts. This study set out to determine if cultural variables might be implicated in Latinos’ increased risk for depression and suicidal behavior, and how they might account for the comparatively higher risk among female Latinas. Results support previous findings that female adolescents report higher depression levels and higher suicidal ideation compared to male adolescents. The results also suggest that generational discrepancies in traditional gender role beliefs are associated with the increase in depression, and that these relationships are mediated by decreases in family functioning. Implications and directions for future research are discussed. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Specific Aims Aim 1: To determine the degree of association between acculturation discrepancy (between adolescent and caregiver), gender role discrepancy, family functioning, and adolescent psychopathology. Hypothesis la: Discrepant acculturation levels between adolescent and caregiver will be associated with lower levels of family functioning, higher levels of adolescent depression, and higher levels of adolescent suicidality. Hypothesis lb: Discrepant gender role beliefs between adolescent and caregiver will be associated with lower levels of family functioning, higher levels of adolescent depression, and higher levels of adolescent suicidality. Hypothesis lc: Lower levels of family functioning will be associated with higher levels of adolescent depression and adolescent suicidality. Aim 2: To determine the extent to which gender moderates the effects of gender role discrepancy on adolescent psychopathology. Hypothesis 2a: Discrepancies in gender role beliefs will be higher for females than for males. Hypothesis 2b: The relationship between gender role discrepancy and adolescent psychopathology will be greater for females than for males. Aim 3: To test hypotheses about the mediators linking cultural variables and adolescent psychopathology. 1 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Hypothesis 3 a: Discrepant levels of acculturation and discrepant gender role beliefs will be associated with increased adolescent psychopathology, and these relationships will be mediated by decreases in family functioning. 2 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Background and Significance Depression and suicidality (suicidal ideation, gestures, or attempts)1 are fairly common in the adolescent population, but reported at even higher rates among Latino adolescents. Researchers have identified many correlates of adolescent depression and suicidality; however, very few studies have addressed the cultural factors that may be implicated in Latino adolescents’ increased risk for these problems. Latinos often experience stresses resulting from the acculturation experience and pressures to conform with gender role expectations, which may negatively impact family functioning as well as the youth’s mental health. The current study set out to determine the extent to which specific cultural factors are associated with mental health problems in Latino youth, and whether these associations are mediated by family dysfunction. Such information may be helpful in understanding why Latino adolescents are at increased risk for depression and suicidality and in identifying treatments that might be most appropriate and beneficial for this population. Ethnic Differences in Youth Depression In a recent national survey of over 13,000 9th through 12th graders (CDC, 2002), Latino adolescents (34%) were significantly more likely than black (28.8%) and white (26.5%) adolescents to have experienced persistent sadness and hopelessness. Among all students surveyed, females (34.5%) reported significantly higher levels of 1 It should be noted that for the purposes o f this paper, completed suicides will not be considered. Completed suicides are less common in the adolescent population compared to other suicidal behaviors such as ideation, gestures, and attempts. For this reason, attention will be restricted to those behaviors that are reported with greater frequency among adolescents. 3 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. sadness and hopelessness than males (21.6%). In particular, Latinas (42.3%) were significantly more likely to report these feelings than white females (32.3%). Other studies of high school students have found similar results. A survey of Latino and African-American high school students showed that Latinos scored significantly higher on a measure of depression (Lester & Anderson, 1992). Roberts and Sobhan (1992) found similar outcomes when they compared Mexican-American and Anglo-American students between 12 and 17 years of age. Mexican-American adolescents were approximately 1.5 times more likely than their Anglo counterparts to report depressive symptoms, even after controlling for age, gender, and socioeconomic status. Overall, depression was found to be higher among females compared to males, and this held true for those of Mexican descent as well (Roberts & Sobhan, 1992). Emslie, Weinberg, and colleagues present further evidence that, among high school students, Latinas report the highest levels of depression (Weinberg & Emslie, 1987; Emslie et al., 1990). Similar findings have been found in younger adolescents as well. Mexican- American junior high students report higher rates of depression compared to their African-American and Anglo-American counterparts (Roberts & Chen, 1995; Roberts, Roberts, and Chen, 1997). These studies also found that females were more likely to report depression than males, with Mexican-American females reporting the highest rates. A meta-analysis published in 2002 reviewed 310 samples of children (N = 61,424) who completed the Children’s Depression Inventory (CDI). Children were 4 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. between the ages of 8 and 16. Overall, Latino children were found to have scored significantly higher on the CDI than both black and white children (Twenge & Nolen-Hoeksema, 2002). Thus, the existing literature strongly suggests that Latino adolescents, particularly adolescent Latinas, are at increased risk for depression. Ethnic Differences in Youth Suicidality Studies also suggest that Latino adolescents are at increased risk for suicidality. For example, Roberts and Chen (1995) found that Mexican-American adolescents reported more suicidal thoughts than their Anglo counterparts. Furthermore, females generally reported more suicidal ideation than males, with Mexican-American females reporting the highest levels of ideation (Roberts & Chen, 1995). Similarly, Lester and Anderson (1992) found that Latino students were more likely to report serious suicidal ideation when compared with African-Americans. These findings are consistent with the results of the 2002 Youth Risk Behavior Survey administered by the CDC. The survey found that Latino and white students were significantly more likely than black students to have seriously considered suicide and to have created a suicide plan. Also, Latino students were significantly more likely than both white and black students to have made a suicide attempt. With regard to gender, female students were significantly more likely than male students to have seriously considered attempting suicide, to have created a suicide plan, and to have attempted suicide. Latina and white females were significantly more likely than black females to have seriously considered suicide, and Latinas were Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. significantly more likely than both white and black females to have made at least one attempt. Across all survey questions about suicide, Latino students were among those reporting the highest rates and Latinas tended to report higher levels than Latino males (CDC, 2002). Similar statistics were reported by the Inter-University Program for Latino Research (IUPLR) at the University of Notre Dame. Reported rates came from high school students in grades 9 through 12 in 1999. Among male high school students, Latinos were slightly more likely than white students to have seriously considered attempting suicide. Among females, a similar pattern was reported with Latinas twice as likely as white females to have considered suicide. Both male and female Latino students were more likely than male and female white students to have made a suicide attempt. The percentage of Latina attempters (18.9%) was considerably higher than the percentage for white females (9.0%). Among male students, Latino and white students had approximately equal rates of injurious suicide attempts (with white students slightly higher.) But among female students, Latinas were more likely than white students to have attempted suicide that resulted in injury (IUPLR website). It is interesting to note that the CDC Youth Risk Behavior Survey data from 1999 showed that Latinas were significantly higher on all survey questions, consistent with the IUPLR data (CDC, 1999). Rates for white adolescents appear to have increased in the three years since the 1999 YRBS, resulting in a convergence between Latino and white adolescents. However, even in the 1999 report, Latino 6 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. adolescents continued to report higher attempt rates than white adolescents. Therefore, despite this increase in rates for white adolescents, it is clear from these reports that Latino adolescents are still at very high risk for suicidal ideation and attempts, and that Latinas are at even greater risk. Factors Contributing to Youth Depression and Suicidality Studies that have explored adolescent depression have found many factors that tend to elevate risk for subsequent depression. Factors range from cognitive style (Turner & Cole, 1994) to poor problem-solving skills (Rudolph, Hammen, & Burge, 1994) to stressful life events (DuBois et al., 1992; Compas et al., 1989). Similarly, a wide array of variables has been identified as correlates of suicidal ideation and suicide attempts among adolescent youth (Spirito et al., 1989; Negron et al., 1997; Lewinsohn, Rohde, & Seeley, 1996). Research has found family functioning, particularly high levels of family conflict and low levels of family cohesion, to be strongly linked to both depression and suicidality (De Wilde et al., 1993; Carlton- Ford, Paikoff, & Brooks-Gunn; Asarnow & Carlson, 1988; Asamow, Carlson, & Guthrie, 1987; Rubenstein et al., 1989). Family Functioning De Wilde et al. (1993) evaluated family conflict and family cohesion among groups of depressed adolescents, adolescent attempters, and non-depressed/non- su icid a l adolescents. Results showed that the depressed and suicide attempt groups reported significantly higher levels of family conflict and significantly lower levels of family cohesion than the non-depressed/non-suicidal group (De Wilde et al., 7 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 1993). Similar results have been found by other researchers (Carlton-Ford, Paikoff, & Brooks-Gunn, 1991; Asamow & Carlson, 1988; Asamow, Carlson, & Guthrie, 1987; Rubenstein et al., 1989). Conflict with parents in particular also appears to be related to adolescent suicide attempts. Adolescent suicide attempters cite parent conflict as the primary cause of their suicide attempt (Miller, Chiles, & Barnes, 1982), and also report significantly more conflict with parents/guardians than matched controls (Corder, Shorr, & Corder, 1974). Conflict with parents has also been found to be associated with gender, with females reporting the greatest degree of parent conflict (Lewinsohn, Rohde, & Seeley, 1993). Conflict with parents has been shown to be relevant to adolescent Latinos. Negron et al. (1997) found that fighting with a parent was the most common antecedent of suicidal behavior for both suicidal ideators and attempters in a group of Latino adolescents. Although this research suggests that family functioning is associated with mental health problems among Latino adolescents, cultural variables that may be associated with family functioning have not been empirically addressed by researchers. For example, cultural variables such as acculturation and marianismo/machismo (gender role beliefs) may impact family functioning among Latinos. Acculturation Acculturation has been defined by the Social Science Research Council (1954) as “the merger of two or more independent cultural systems, leading to dynamic 8 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. processes that include the adaptation of value systems and transformation within relationships and personality traits” (p. 974). During acculturation, change can occur along various domains including beliefs, values, and behavioral practices (Kaplan & Marks, 1990). Oftentimes, the term assimilation is used interchangeably with the term acculturation. However, assimilation is only one of four modes of acculturation that have been identified. Berry and Kim (1988) describe these four modes. Assimilation is the process whereby the acculturating individual becomes part of the mainstream society while simultaneously losing all connections to the native culture. Integration, a second mode of acculturation, allows the acculturating individual to become part of the larger society while still retaining his/her own cultural values, beliefs, and behavior. Separation occurs when the acculturating individual chooses to withdraw from the dominant society. Marginalization, the final mode of acculturation, describes the process by which the acculturating individual loses contact with both the native culture and mainstream society. Research generally uses the term acculturation to describe the assimilation and integration modes. In other words, the term acculturation is used to define the extent to which an individual is oriented to the mainstream culture. To retain consistency with existing literature, the term acculturation will be defined in this way for the purposes of the current study. Research on the relationship between acculturation and depression is inconsistent. Additionally, a good part of the research has focused on adult or young adult samples. Rogler et al (1991) reviewed thirty studies on acculturation and 9 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. mental health and found that some studies supported a positive association between acculturation and mental health, whereas others supported negative associations. For example, Kaplan and Marks (1990) looked at the association between acculturation and psychological distress in two groups of adult Mexican-Americans, a younger adult group (ages 20 to 30) and an older adult group (ages 31 to 50). Results showed that acculturation was positively associated with psychological distress in the younger adult group, but negatively associated in the older adult group. Mexican- American male adults who are more acculturated have also been found to report lower levels of depression than those who are less acculturated (Neff & Hope, 1993). More recently, a study by Cuellar and Roberts (1997) found that acculturation status had no significant influence on depression levels among acculturating Mexican- American college students. However, there was a tendency for assimilated students to report low levels of depression again suggesting a negative association. Unfortunately, research examining the association between acculturation and depression among Latino adolescents is virtually non-existent. In a comparison between Mexican-American adolescent students and Mexican adolescent students, Mexican-American students reported higher rates of depressive symptoms (Swanson et al., 1992). Although the authors suggested that acculturation may play a role in explaining this difference, they did not measure acculturation per se. To my knowledge, a study by Hovey and King (1996) was the only one to evaluate the relationship between acculturation and depression among Latino-American adolescents. They found that approximately 23% of Latino-Americans reported 10 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. critical levels of depression (indicating significant psychopathology) compared with 12% of the standardization sample of a depression measure. Furthermore, Latino- American adolescents who reported higher levels of acculturative stress were also more likely to report higher levels of depression. Research examining the effects of acculturation on suicidality among Latino adolescents is also sparse. Swanson and colleagues found that Mexican-American adolescents reported higher rates of suicidal ideation compared with Mexican adolescents, (Swanson et al., 1992). Although the authors did suggest the possible role of acculturation, acculturation was not assessed. Hovey and King (1996) appear to have conducted the only study that empirically examined the link between acculturation and suicidality among adolescent Latinos. They found that 25% of Latino youth reported critical levels of suicidal ideation, in contrast to 11% of the standardization sample of a suicidality measure. As with depression, they discovered that Latino-American adolescents who reported higher levels of acculturative stress were also more likely to report higher levels of suicidal ideation. These studies examined the association between an individual’s level of acculturation and his/her levels of depression and suicidality. The present study offers a different way of viewing the association between acculturation and mental health problems. This study will look at acculturation discrepancy between adolescent and caregiver. This discrepancy refers to the difference between the adolescent’s level of acculturation and his/her perception of the primary caregiver’s level of acculturation. The association between this discrepancy and subsequent 11 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. mental health problems (such as depression and suicidality) will be examined. Kaplan and Marks (1990) found that acculturation and psychological distress were positively associated for Mexican-American young adults, but negatively associated for older adults. They suggested that adopting Anglo-American values might isolate the younger adult from his or her source of social support. The present study takes a rather similar view. The adoption of Anglo-American values (increased acculturation) is hypothesized to increase conflict and decrease cohesion within the family. These decreases in family functioning will result because the acculturating adolescent will be adopting values, beliefs, and behaviors that are very different from those of his/her caregiver. These differences will increase conflict and decrease cohesion in the family thereby increasing the adolescent’s risk for mental health problems. Marianismo/Machismo The terms marianismo and machismo describe the differential sex role expectations for males and females in Latino culture. Marianismo refers to the expectation for Latina women to be acquiescent and dutiful, and to refrain from questioning their husbands’ actions or activities. From this perspective, the primary responsibilities of the Latina woman are to raise the children and care for the home (Soto, 1983). She is also expected to devote herself to her family, and is discouraged from pursuing academic or professional goals (Senour, 1977). The term marianismo derives from Catholic representations of the Virgin Mary, who is venerated as a symbol of saintliness, self-sacrifice, and emotional suffering (Nieto, 1997; 12 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. NietoGomez, 1997). Marianismo contrasts with the value of machismo, which describes the Latino man as a strong, assertive, and dominant figure in the family. He is brave and powerful and is expected to protect his family (Grebler, Moore, & Guzman, 1970). Machismo also signifies a “strong sense of personal honor and family loyalty” (p. 243, Ruiz, 1977). No research to date has considered this sex role differentiation and its implications for adolescent psychopathology. However, sex role beliefs have been studied in relation to acculturation. Specifically, greater acculturation has been found to be positively associated with less traditional attitudes toward women among Latina adults (Kranau, Green, & Valencia-Weber, 1982). This suggests that as one becomes more acculturated, mainstream attitudes toward women begin to replace more traditional Latino attitudes. Consistent with this finding, Kranau and his colleagues found that increased acculturation was also associated with decreased feminine role-type behaviors. More highly acculturated Mexican-American parents have also been found to endorse more egalitarian gender attitudes (Leaper & Valin, 1996). Just as discrepancies in acculturation can develop between a Latino adolescent and his/her caregiver, sex role beliefs can also be discrepant within the family system. As with acculturation discrepancy, generational discrepancies in endorsement o f marianismo/machismo beliefs is hypothesized to make Latino adolescents more susceptible to depression and suicidality by increasing family conflict and decreasing family cohesion. 13 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Family Functioning and Cultural Variables With regard to cultural variables, it has been suggested that low levels of family functioning are related to acculturative stress (Hovey & King, 1996), which was defined as stress that results from perceived discrimination and feelings of exclusion occurring in social, familial, and environmental contexts. There is also theoretical support for an association between family functioning, acculturation, and adolescent behavior. Szapocznik (1989) describes a High Risk Syndrome which, if present in families, may cause behavior problems in Latino adolescents. The High Risk Syndrome is an interrelationship among three familial risk factors: maladaptive interactions, intergenerational conflict, and intercultural conflict. Szapocznik claims that intercultural conflict is frequently the result of acculturation, and results when there are differing cultural beliefs between the youth and caregiver. Intercultural conflict is often coupled with intergenerational conflict for this reason. Typically, the parents are more strongly tied to traditional beliefs or values, whereas the youth is more strongly tied to the beliefs and values of the mainstream culture. Within the High Risk Syndrome framework, this discrepancy adds stress to the family’s already maladaptive interaction patterns. This reduction in adaptive family functioning can begin to produce problematic (or suicidal) behavior on the part of the adolescent. This theory is consistent with the hypotheses proposed in this study; conflict between a youth and his/her caregiver is hypothesized to be associated with specific problematic behavior such as suicidality. 14 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Proposed Mechanism and Model of Depression and Suicidality in Latinos It is hypothesized that discrepancies in acculturation and gender role beliefs will be associated with increased levels of depression and suicidality in adolescent Latinos. Furthermore, it is believed that the relationship between these culture- linked factors and mental health functioning will be mediated by decreases in family functioning. Reduced family functioning is expected to result from increased family conflict and decreased family cohesion, which are expected to result from adolescent-caregiver discrepancies in acculturation levels and gender role beliefs. Gender is expected to moderate the effects of gender role discrepancy on adolescent mental health, with females experiencing more discrepancy and reporting more mental health problems. This study sets out to understand the context in which Latino adolescents become depressed and report suicidal ideation or suicide attempts. It may be that the increased rates of depression and suicidality among Latino adolescents are due to increased non-cultural risk factors (such as poor coping skills and reduced social support). Perhaps, however, specific cultural variables increase a Latino adolescent’s risk for depression and suicidality. This study sets out to determine the extent to which this may be the case. 15 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Experimental Design and Methods Source and Description of Participants Participants were 117 ninth and tenth grade students enrolled at Foshay Learning Center in Los Angeles. Students ranged in age from 13 to 16 (mean = 14.39, SD = .72), with 68.4% of the sample being females. Students were Latino (81.2%), Black/African-American (13.7%), White (1.7%), Asian (1.7%), or biracial Latino and Black/African-American (1.7%). Latino students came from a variety of backgrounds, though most students were of Salvadoran or Mexican background (51%). Power Analysis In order to obtain power equal to .80, while finding at least a medium effect size, a sample size of approximately 125 adolescents is required (Rosenthal & Rosnow, 1991). Measures: Demographics. Information about age, race/ethnicity, place of birth, age of immigration (if applicable), religion, parent occupation, and parent education were obtained through a self-report questionnaire developed for youth. Acculturation. Acculturation level was evaluated through self-report on the Acculturation Rating Scale for Mexican-Americans-II (ARSMA-II, Cuellar, Arnold, and Maldonado, 1995). This questionnaire was completed only by Latino youth because of its emphasis on the Spanish language. Latino youth completed this questionnaire twice: once for themselves and a second time for their caregivers. It 16 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. should be emphasized that caregivers did not participate in this study and that no information was obtained directly from the caregivers. The instructions asked the youth to select a parent or caregiver with whom they spent the most time at home and to complete the questionnaire as if they were that adult. Youth were also asked to indicate the nature of their relationship with this adult on the form. The ARSMA-II is an orthogonal, multidimensional measure of cultural orientation and modes of acculturation. The first scale of the ARSMA-II consists of 30 items rated on a 5-point Likert scale. These items are used to assess Mexican orientation and Anglo orientation, as well as the assimilation and integration modes of acculturation. The second scale of the ARSMA-II, consisting of 18 items rated on a 5-point Likert scale, is used to assess the marginalization and separation modes of acculturation. Information about generation status is also obtained on the ARSMA- II. For the purposes of the current study, only the first scale of the ARSMA-II was administered. Items from the first scale of this measure include “I enjoy Spanish language TV,” “My friends now are of Anglo origin,” and “I like to identify myself as a Mexican-American.” Because the scale is intended to be administered to individuals of Mexican descent, many of the items use “Mexico” and “Mexican- American.” For this study, the standard directions were altered to allow individuals to substitute in their native country. Individual items were also altered to reflect this change. These changes were made for both the youth and the caregiver versions of the questionnaire." 2 Although instructions and individual items were altered to allow youth to complete the questionnaire based on their own cultural background, we have retained the label o f “Mexican Orientation Scale” for consistency with the original scale. 17 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. A reliability analysis produced an alpha of .58 for the youth Anglo orientation scale and .88 for the caregiver version. The Mexican orientation youth scale produced an alpha of .80 while the caregiver version produced an alpha of .77. In order to measure acculturation discrepancy, a residualized regression approach was used to measure the magnitude of the difference between child and caregiver scores. An acculturation score was determined by subtracting the Mexican orientation score from the Anglo orientation score, as instructed by the authors. The child’s acculturation score was then regressed onto the caregiver’s score to determine how much of the child’s score was predicted by the parent’s score. The residual was then saved as a standardized score and used in subsequent analyses as a measure of discrepancy. It should be noted that the direction of the discrepancy is irrelevant (i.e., whether the adolescent is more or less acculturated than the caregiver). What is important is the magnitude of the discrepancy. For this reason, the absolute value of the standardized score was used. Gender Role Beliefs. Gender role beliefs were evaluated through self-report on the Attitudes toward Women Scale (AWS, Spence, Helmreich, & Stapp, 1973), the Machismo Scale (Cuellar, Arnold, & Gonzalez, 1995), and a Marianismo Scale developed specifically for this study. All youth completed these questionnaires. As with the acculturation measure, these questionnaires were completed two times: once for the adolescent and a second time for the caregiver. For the caregiver version, the instructions asked the youth to choose a parent or caregiver with whom they spent the most time at home and to complete the questionnaires as if they were that adult. 18 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Youth indicated the nature of their relationship with this adult on the form. The short version of the AWS is a 25-item measure that assesses the extent to which the individual holds more traditional or less traditional views of the female role. Items are rated on a 4-point Likert scale. Items from this measure include “Women should worry less about their rights and more about becoming good wives and mothers” and “Women should have the same place in the job market as men.” Item phrasing was simplified to facilitate adolescent comprehension. In all cases, efforts were made to retain the original meaning of the statement. A few items were also altered in order to make the language more modem. For example, the phrase “dam socks” was changed to “sew socks.” All items were summed to obtain a total AWS score, with higher scores indicating less traditional views. A reliability analysis on this measure produced an alpha of .76 for the youth version and .69 for the caregiver version. The Machismo Scale is a 17-item scale composed of four factors: male superiority, male gender role, female gender role, and male strength. Items from this measure include “There are many jobs that should go to men instead of women,” “Men are smarter than women,” and “Wives should respect the man's position as head of the household.” Items from the Machismo Scale were similarly simplified in language. Although the original measure used a true-false response format, a 4-point Likert scale was used for this study. This allowed format consistency with the AWS and allowed more variation in student responses. Normally, higher scores on the Machismo Scale indicate more traditional beliefs. However, to keep consistent with 19 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. the AWS, this measure was scored by the same method, with higher scores indicating less traditional gender role beliefs. A reliability analysis of the Machismo scale produced an alpha of .83 for the youth version and .82 for the caregiver version. In addition to these two measures, 14 additional items assessing gender role beliefs were developed in order to tap traditional Latino gender role beliefs that were not addressed by either the AWS or the Machismo Scale. Items for this Marianismo Scale were developed based on descriptions of traditional Latino gender roles offered by several authors (Soto, 1983; Senour, 1977; Nieto, 1997; NietoGomez, 1997; Grebler, Moore, & Guzman, 1970). Sample items include “A woman should put her husband’s and child’s needs before her own” and “Wives should obey their husbands.” This measure was also scored in the same way as the AWS and the Machismo Scale to keep the measures consistent, with higher scores indicating less traditional beliefs. A reliability analysis produced an alpha of .62 for the youth version and .55 for the caregiver version. Due to these low alpha levels, five items were removed from each version through an iterative process yielding new alpha coefficients of .72 for the youth version and .68 for the caregiver version. The amended version of the Marianismo Scale was used for all statistical analyses. A composite score was calculated for the three gender role measures by summing each of the three scales. As with the acculturation measure, a residualized regression approach was used to measure the magnitude of the difference between caregiver and adolescent scores on each gender role belief measure and on the composite 20 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. score. The child’s gender role score was regressed onto the caregiver’s score to determine how much of the child’s score was predicted by the parent’s score. The residual was then saved as a standardized score and the absolute value was taken. This process was completed for the AWS, Machismo Scale, Marianismo Scale, and composite score, yielding four indices of gender role discrepancy. Family Functioning. Family functioning was evaluated through self-report on the Conflict subscale of the Family Environment Scale (FES; Moos & Moos, 1981) and the Cohesion subscale of the Family Adaptability and Cohesion Evaluation Scale (FACES-III; Olson, Portner, & Lavee, 1985). The FES is a true-false measure that assesses family functioning. It consists of 10 subscales, one of which is a Conflict subscale. This subscale consists of 9 items, and yielded an alpha of .73. Items from this subscale include “We fight a lot in our family” and “Family members often criticize each other.” The FACES-III is a 20-item measure designed to assess two aspects of family functioning: family cohesion and family adaptability. This study utilized the 10-item Cohesion subscale. Items from this subscale include “We like to do things with just our immediate family” and “Family members consult other family members on their decisions.” Both the Conflict and Cohesion subscales have been shown to discriminate between adolescents with and without psychopathology such as depression and suicidality (Asamow, Carlos, & Guthrie, 1987; De Wilde et al., 1993; Asarnow & Carlson, 1988; Rubenstein et al., 1989). With regard to internal consistency, the Cohesion subscale produced an alpha of .83. 21 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Depression. Depression was evaluated through self-report on the TeenScreen (Shaffer, 1996) and Reynolds Adolescent Depression Scale-2 (RADS-2, Reynolds, 2002). The TeenScreen is a brief questionnaire that assesses depression, substance use, and suicidal thinking and behavior among teenage youth. It is a school-based screening instrument that aims to identify youth who are at high risk for suicide. Specificity of the TeenScreen is 70% when its sensitivity is set at 80%. Specificity refers to the proportion of negative cases (those without a particular attribute) that are identified by an instrument. Sensitivity refers to the proportion of positive cases (those with a particular attribute) that are identified by an instrument. When compared with the Beck Depression Inventory, the TeenScreen’s specificity was 81% for a cutoff score of 16 and 87.8% for a cutoff score of 21. For these same cutoff scores, sensitivity was 65.6% and 48.8%, respectively. Three TeenScreen items, rated on a 5-point Likert scale, were used to create a depression index. These items were “In the past month, how much of a problem have you had with feeling unhappy or sad,” “In the past month, how much of a problem have you had with losing your temper, being in a bad mood, or little things making you mad or upset,” and “In the past month, how much of a problem have you had with feeling you don’t want to be with people, even your friends?” A reliability analysis for this measure produced an alpha of .80. The RADS-2 is a 30-item measure that assesses depressive symptomatology along four dimensions: dysphoric mood, anhedonia/negative affect, negative self- 22 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. evaluation, and somatic complaints. Items from this measure include “I feel happy” and “I feel life is unfair.” A reliability analysis produced an alpha of .91. Suicidality. Suicidality was evaluated through self-report on the TeenScreen (Schaffer, 1996). To my knowledge, there is no psychometric information available for the suicidality items of the TeenScreen. However, there is support for the predictive validity of these items: the TeenScreen can identify approximately two- thirds of youth who will go on to experience suicide or depression in their early twenties. The TeenScreen assesses recent (past year) suicidal ideation using two yes/no questions: “During the past year, have you thought about suicide, that is, killing yourself?” and “In the last year, has there been a time when you thought seriously about killing yourself?” Suicidal ideation was indicated by an affirmative response to either item. Suicide attempts were assessed using a single question from the TeenScreen: “Have you tried to kill yourself in the past year?” If the youth answered “yes” to this item, he/she was considered a suicide attempter. Procedure: Active consent for participation was obtained from each youth’s primary caregiver. Consent packets were distributed to all students in 9th and 10th grade homeroom classes. A cover letter provided brief information about the study. All adolescents who returned signed consent forms were assented and administered the questionnaire packet in a group setting during their physical education class period. Students who were not enrolled in physical education completed the questionnaires during a non-core academic class. Permission was requested in advance from all 23 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. teachers to allow students to miss a portion of class. Youth underwent a one-time assessment where they were asked to complete the demographics questionnaire, ARSMA-II, AWS, Machismo Scale, Marianismo Scale, conflict subscale of the FES, cohesion subscale of the FACES-III, TeenScreen survey, and RADS-2. Youth also completed the ARSMA-II, AWS, Machismo Scale, and Marianismo Scale from the perspective of their primary caregivers. The primary caregiver was defined as the parent or guardian that the youth spends the most time with at home. The youth was asked to record the relationship of this caregiver at the top of the questionnaire. By having adolescents complete these measures for themselves and for their caregivers, we were able to construct a measure of perceived discrepancy. It should be emphasized that caregivers did not directly report on their own acculturation level or belief in traditional gender roles. The full assessment took between 25 and 60 minutes to complete and was administered in a group setting. Youth were paid $5 for their participation. To ensure confidentiality and the participants’ privacy, all questionnaires were administered anonymously. A precedent has been set for the anonymous assessment of suicidality in school-based populations, and studies have suggested that anonymous surveys increase the validity of the assessment (Safer, 1997; Harkavy Friedman et al., 1987; Swadi, 1990; Hawton et al., 2002). 24 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Data Analysis All data obtained were first examined for missing data, outliers, and deviations from normality. Missing data were treated using mean substitution based on values reported by all other students. If a participant was missing more than 10% of the items on a given measure, the participant was excluded from analyses involving that measure. Outliers were determined using both statistical and graphical methods. Scores for all measures were standardized with any scores in excess of ±3 standard deviations from the mean considered outliers (Tabachnick & Fidell, 2000). Deviations from normality were determined by graphical methods (Tabachnick & Fidell, 2000). Variables that did not meet the assumptions for normality were transformed. 25 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Results Independent t-tests (for continuous variables) and chi square analyses (for dichotomous variables) were first conducted to determine whether males and females differed significantly in their responses on measures of depression and suicidality. Table 1 reports means, standard deviations, and t-ratios for all t-tests conducted. A significant gender difference was found for depression as assessed by both the RADS and the TeenScreen, with females reporting significantly higher levels of depression. A significant gender difference was also found for suicidal ideation, with females reporting higher levels, x2=7.58, p<.01, (22% of females and 2% of males reported ideation). No significant difference was found for attempted suicide, % 2=.683, ns, (8% of females and 2% of males reported suicide attempts). In order to test hypotheses under aim 1, correlational analyses were conducted to test for significant associations among the variables (see Table 2). It was hypothesized that acculturation discrepancy and gender role discrepancy would be positively associated with students’ mental health problems and negatively associated with family functioning. Analyses involving acculturation discrepancy were restricted to Latino students, as they were the only students to fill out the acculturation measure. No significant correlations were found between acculturation discrepancy and any of the family functioning or mental health variables. Discrepancy scores were also calculated for the individual Mexican orientation scale and Anglo orientation scale. Mexican orientation discrepancy was found to be associated with suicide attempts. 26 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced w ith permission o f th e copyright owner. Further reproduction prohibited without permission. Table 1: Independent Sample Statistics: Male and Female Scores on Depression and Gender Role Beliefs Measures Male Female Measure Mean SD Mean SD t df Sig. RADS Depression 54.18 15.42 61.08 13.57 -2.44 114 .016 TS Depression 2.45 .63 2.76 .45 -3.03 115 .003 AWS 47.05 7.26 56.06 7.91 -5.86 114 .000 Machismo Scale 29.16 8.65 38.42 6.54 -6.39 114 .000 Marianismo Scale 25.54 5.49 29.39 4.16 -4.19 114 .000 Composite Scale 101.76 18.45 123.87 15.95 -6.62 114 .000 AWS Discrepancy .745 .589 .902 .547 1.68 114 .097 Machismo Discrepancy 1.04 .699 .695 .486 3.05* 114 .003 Marianismo Discrepancy .975 .758 .652 .563 2.58* 114 .011 Composite Discrepancy .959 .627 .654 .552 2.66 114 .009 K > - J Note: *Equal variances cannot be assumed With regard to gender role beliefs, a significant correlation was found between AWS discrepancy and family cohesion and between Machismo discrepancy and TeenScreen depression (see Table 2) . Greater discrepancy on the AWS scale was associated with lower levels of family cohesion while greater discrepancy on the Machismo scale was associated with lower levels of depression. No other significant correlations between the discrepancy and outcome variables were found. Under Aim 1, it was also hypothesized that lower levels of family functioning would be positively correlated with students’ mental health problems. Significant correlations were found between family cohesion, family conflict, depressive affect, and suicidality (see Table 2). Higher levels of family dysfunction (as assessed by measures of family cohesion and family conflict) were associated with higher levels of depression (as assessed by both the RADS and the TeenScreen), higher levels of suicidal ideation, and a higher frequency of attempted suicide. It was hypothesized under Aim 2 that discrepancies in gender role beliefs would be higher for females than for males. Independent t-tests were conducted to test for gender differences in both gender role beliefs and in gender role belief discrepancy (see Table 1). On each of the three gender role measures (AWS, Machismo Scale, and Marianismo Scale) and the composite gender role scale, females scored significantly higher than males, indicating that females held less traditional views. Independent t-tests showed significant differences in gender role discrepancy for two of the three gender role measures (Machismo Scale and Marianismo Scale) and for 3 Correlational analyses for gender role discrepancy, family functioning, depression, and suicidality were also conducted with Latino participants only. N o significant differences were found between these correlations and those that included both Latino and non-Latino participants. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced w ith permission o f th e copyright owner. Further reproduction prohibited without permission. Table 2: Correlations Between Discrepancy Variables. Family Cohesion, Family Conflict, Depressive Affect, and Suicidality (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) Acculturation Discrepancy .396** .127 -.034 -.094 .034 -.035 -.058 -.010 -.067 .045 -.077 -.099 Mexican Orientation Discrepancy Anglo Orientation Discrepancy ----- .259* .023 -.118 .105 -.078 .120 .068 .116 -.072 .021 -.081 -.053 .120 .006 .179+ -.123 .010 .090 .159 .213* .055 AWS Discrepancy . — .484** .405** .816** -.194* .154 .118 .158+ .143 .083 MS Discrepancy . . . .558** .835** -.121 -.047 -.055 -.190* .001 -.013 M M S Discrepancy . . . .657** .082 -.014 -.054 -.115 .006 .023 Gender Role Composite Discrepancy . . . -.116 .062 .042 -.016 .122 .015 Family Cohesion . . . -.347** -.356** -.373** -.199* -.123 to so Reproduced w ith permission o f th e copyright owner. Further reproduction prohibited without permission. Table 2: Correlations Between Discrepancy Variables, Family Cohesion. Family Conflict, Depressive Affect, and Suicidality ('Continued) Family Conflict — .435** .339** .311** RADS Depression — .633** .404** TeenScreen Depression — .408** TeenScreen Ideation TeenScreen Attempt Note. For statistical analyses involving the acculturation measure, non-Latino students were excluded from the analysis. Correlation coefficients are consequently based on varying number o f cases (n = 94-117). *g<.05. **g<01 +j><. 10 o .161 + .273** .224** .602** the composite gender role scale. Boys reported higher discrepancy scores on these three measures. Gender differences in AWS discrepancy scores were only marginally significant, with females reporting higher discrepancy scores. It was also hypothesized under Aim 2 that gender would moderate the relationship between gender role discrepancy and mental health problems. Hierarchical regression analysis was used to test this hypothesis. Gender was tested as a moderator for all combinations of gender role discrepancy and outcome associations (e.g., AWS discrepancy and TeenScreen depression, AWS discrepancy and RADS depression, etc.) The only significant interaction effect was found for the association between Machismo discrepancy and TeenScreen depression. The results are shown in Table 3. A plot of the regression lines shows that, while there is a negative association between discrepancy and depression for males, there is a positive association for females (see Figure 1). Aim 3 hypothesized that family functioning would mediate the relationship between discrepancy and psychopathology. In order to test for mediation, four conditions must be satisfied (Holmbeck, 1997). The first condition is that the predictor-mediator path (discrepancy-family functioning path) must be significant. The second condition is that the predictor-outcome path (discrepancy- psychopathology path) must be significant. The third condition is that the mediator- outcome path (family functioning-psychopathology path) must be significant. The fourth condition for mediation is that the association between the predictor and outcome should be significantly reduced once the mediator is controlled. In this 31 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Table 3: Results of Hierarchical Regressions Testing for Gender as Moderator of the Machismo Discrepancy and Depression Association Predictor Beta t Sig. Machismo Discrepancy -.113 -1.20 .231 Gender .240 2.56 .012 Discrepancy X Gender .264 2.81 .006 study, only the AWS discrepancy-family cohesion-TeenScreen depression set of relationships met the first three criteria (see Table 4). Sobel’s test was used to statistically determine whether the final criterion was met (Baron & Kenny, 1986). This test showed that family cohesion fully mediated the relationship between AWS discrepancy and TeenScreen depression, although this finding was only marginally significant, t= -1.76, p<.10. 32 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TeenScreen Depression Score Figure 1: Machismo Discrepancy and Gender Interaction Effect on TeenScreen Depression 5 1 ---------------------------------------------------------------- 4 - 2 1 - 0 H ---------------------- 1 ---------------------- 1 ------------ -1 0 1 Machismo Discrepancy Male Female Table 4: Results of Hierarchical Regressions Testing for Family Cohesion as Mediator of the AWS Discrepancy and Depression Association Variable Beta t Sig. AWS Discrepancy - Cohesion not controlled .158 1.71 .09 - Cohesion controlled .096 1.08 .282 33 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Discussion The primary purpose of this study was to determine what factors are associated with adolescent psychopathology, and whether cultural context variables might be implicated in Latino adolescents’ increased risk for psychopathology. Findings suggest that family dysfunction is associated with increased depression and suicidality among adolescents. Overall acculturation discrepancy does not appear to be implicated in Latino adolescents’ increased risk for psychopathology; however Mexican orientation discrepancy is associated with increased suicide attempts. Discrepancy in gender role beliefs is associated with increased mental health problems among all adolescents, and this holds true for Latino adolescents. Consistent with previous research (CDC, 2002; Roberts & Sobhan, 1992; Emslie et al., 1990; Weinberg & Emslie, 1987; Roberts & Chen, 1995; Roberts, Roberts, & Chen, 1997; Twenge & Nolen-Hoeksema, 2002), this study found that female adolescents experience more depression and engage in more suicidal ideation than male adolescents. It was hypothesized that a higher rate of gender role discrepancy would be reported by females and that this discrepancy would be associated with higher rates of psychopathology. This was not found to be true. In fact, males reported higher rates of gender role discrepancy across three of the four gender role measures. However, the discrepancy X gender interaction effect provides evidence that for females, gender role discrepancy is associated with increased depression. For males, the opposite is true; discrepancy is associated with a decrease in depression level. Consequently, there appears to be some evidence that gender role 34 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. discrepancy is associated with increased risk for psychopathology; however, this risk may exist only for females. This is consistent with previous findings that conflict with parents is associated with adolescent depression (Miller, Chiles, & Barnes, 1982; Corder, Shorr, & Corder, 1974; Lewinsohn, Rohde, & Seeley, 1993). Although there is no current research examining the degree to which gender role beliefs are associated with adolescent mental health, the association found in this study is consistent with existing evidence and theory that family conflict and intergenerational conflict are associated with adolescent psychopathology (Miller, Chiles, & Barnes, 1982; Corder, Shorr, & Corder, 1974; Lewinsohn, Rohde, & Seeley, 1993; Negron et al., 1997; Szapocznik, 1989). It was also hypothesized that acculturation discrepancy would be associated with adolescent psychopathology. No evidence was found to support this hypothesis. However, analyses of the discrepancy scores that were based on the two acculturation subscales revealed that Mexican orientation discrepancy was positively associated with suicide attempts. These findings provide evidence that, while discrepancies in specific aspects of cultural orientation appear to be associated with mental health problems, discrepancy in overall acculturation level does not. These results parallel the mixed findings that currently exist in the literature, where both significant and non-significant associations between acculturation and psychopathology have been found (Rogler et al., 1991; Cuellar & Roberts, 1997; Swanson et al., 1992; Hovey & King, 1996). Acculturation is a complex construct and is likely to comprise multiple domains. Further research is needed to clarify 35 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. what acculturation actually is and how it should be measured. The inconsistent findings may be evidence that researchers are tapping different constructs when they claim to be assessing “acculturation.” In the current study, acculturation was calculated by subtracting the Mexican orientation score from the Anglo orientation score. However, it is unclear whether this is an appropriate method for evaluating Latino acculturation. Higher depression and suicidality levels were found to be associated with higher family dysfunction (higher family conflict and lower family cohesion), as reported in previous research (De Wilde et al., 1993; Asarnow & Carlson, 1988; Asarnow, Carlson, & Guthrie, 1987; Rubenstein et al., 1989). Family cohesion was found to mediate the relationship between AWS discrepancy and TeenScreen depression. This finding suggests that the mechanism by which gender role discrepancy influences depression level is through reductions in family cohesion. This is consistent with the theory that adopting values or beliefs that are different from those held by other family members may isolate the individual and reduce social support (Kaplan & Marks, 1990). The results of this study confirmed previous findings that females report higher levels of depression and suicidal ideation compared to males. Higher levels of psychopathology were significantly associated with lower levels of family dysfunction, also supporting previous findings. Some evidence was found to suggest that family dysfunction may be attributable to discrepant beliefs or values between adolescents and their caregivers, and that family dysfunction may mediate the 36 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. relationship between discrepancy and subsequent psychopathology. Szapocznik (1989) theorized that problematic behaviors among adolescents are attributable to intergenerational and intercultural conflict within the family. The findings of the current study provide preliminary empirical evidence that this may be the case. Limitations: There are several methodological limitations to the current study. The first is the disproportionate gender and ethnicity split in the study sample. The study consisted of 68% female participants and 81% Latino participants. Given that the primary concern of this study was to understand the culture-linked determinants of certain mental health problems among Latino youth, the relatively large number of Latinos permitted for adequate power when restricting analyses to this population. However, the low percentage of non-Latino participants did not permit analyses restricted to non-Latino youth. Another limitation of this study was that caregivers did not participate. Information concerning caregivers’ acculturation and gender role beliefs was obtained via adolescent report. For this study, the research design was appropriate because the interest was in perceived discrepancy and not in actual discrepancy. However, due to the limitation of this research design, is it impossible to make any conclusions about the caregivers’ actual acculturation levels or gender role beliefs and their direct associations with adolescent mental health. A final limitation of this study was that acculturative stress was not assessed. Previous research has reported that acculturative stress is associated with mental Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. health problems (Hovey and King, 1996). Perhaps the reason that acculturation discrepancy was not associated with adolescent psychopathology was because the discrepancy was not experienced as stressful. A measure of acculturative stress may have helped to determine whether or not the acculturation process was experienced as stressful or negative. The acculturation measure that was used in this study assessed factors such as frequency of watching TV in either Spanish or English, reading and writing in either Spanish or English, and listening to Latin or American music. Perhaps adolescent-caregiver differences on these types of variables are not important or stressful. Differences in gender role beliefs, on the other hand, which involve differences that are more relevant to self-concept, self-identity, and societal role, may be more important. These differences may be experienced more negatively. The findings of this study suggest that this may be the case. Implications and Directions for Future Research This study suggests that family dysfunction, as assessed by increased conflict and decreased cohesion, is an important correlate of adolescent mental health problems. Stressors that might increase family dysfunction should be considered when treating adolescents with psychopathology. This study found that discrepant beliefs with respect to traditional Latino gender roles are associated with decreased family functioning. Assessment of these factors should be strongly considered when providing mental health services to Latino adolescents. Research should continue to explore the role that cultural variables play in adolescent mental health. Acculturation continues to be a variable that produces 38 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. equivocal findings with respect to mental health outcomes. Perhaps a study that assesses acculturation via multiple methods and via multiple informants will provide more information. Additionally, measures of acculturative stress should be included to determine whether the acculturation experience is a negative or stressful one. Given the preliminary findings from this study suggesting that discrepant gender role beliefs may be implicated in adolescent psychopathology, research must shift its attention to this area as well. Researchers should also look towards refining the existing measures of acculturation and gender role beliefs and improving both their construct validity and their psychometric properties. 39 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. References Asamow, J. R. & Carlson, G. (1988). Suicide attempts in preadolescent child psychiatry inpatients. Suicide and Life-Threatening Behavior. 18(2J, 129-136. Asamow, J. R., Carlson, G. A. & Guthrie, D. (1987). Coping strategies, self perceptions, hopelessness, and perceived family environments in depressed and suicidal children. Journal of Consulting and Clinical Psychology. 55(3). 361-366. Baron, R.M. & Kenny, D.A. (1986). 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Creator Cespedes, Yolanda M. (author)

Core Title Depression and suicidality in Latino adolescents: A study of acculturation and gender role beliefs

School Graduate School

Degree Master of Arts

Degree Program Psychology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,Psychology, clinical,sociology, ethnic and racial studies

Language English

Contributor Digitized by ProQuest (provenance)

Advisor [illegible] (committee chair), [illegible] (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-317054

Unique identifier UC11336811

Identifier 1422386.pdf (filename),usctheses-c16-317054 (legacy record id)

Legacy Identifier 1422386.pdf

Dmrecord 317054

Document Type Thesis

Rights Cespedes, Yolanda M.

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA