Self-rated health and mortality: does the relationship extend to a low income setting?

Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be poor are significantly more likely to die in subsequent follow-up periods than their counterparts who view their health as good. This result characterizes both men and women, holds for multiple time periods, and remains after inclusion of measures of nutritional status, physical functioning, symptoms of poor physical health and depression, and hypertension. We also consider the correlates of self-rated health. Symptoms and physical functioning are strong predictors of reporting poor rather than good health, but neither these indicators nor other covariates we consider distinguish between reports of excellent rather than good health.     

Correlates of Depression among Chinese Immigrant Elders in Arizona: The Role of Acculturative Stress and Social Support

Using the stress and coping framework, we examined the association between acculturative stress, social support, and depression among Chinese immigrant elders living in Arizona. This cross-sectional study used a snowball sample of 120 respondents. Multiple regression results suggest that English language proficiency, health status, and gender were significant correlates of depression. Findings justify creating intervention programs that target Chinese immigrant elders who are less proficient in English, female, and in poor health. Future research and implications are discussed.     

Moderating Effects of School Ethnic Composition of Acculturative Stress and Academic Outcomes in Latinx Youth

Acculturative stress has demonstrated significant negative relationships with Latinx students' academic outcomes. Framed through interpersonal contact theory, we examined the moderating roles of school ethnic representation (proportion of same-ethnic peers) and school ethnic diversity (proportion of different ethnic groups in student body) in the relationship between acculturative stress and both academic self-efficacy and school belonging. A sample of 190 Latinx youth (14–18 years old) completed measures of acculturative stress and school functioning, and they provided the name and location of their high school to facilitate calculation of school ethnic composition. Both ethnic representation and ethnic diversity moderated relationships between English Competency Pressure (ECP), a specific form of acculturative stress, and academic-self efficacy. School ethnic diversity also interacted with ECP to predict school belonging. Negative relationships between ECP and academic self-efficacy or school belonging only emerged for students in schools with very low ethnic diversity. In contrast, ECP was significantly negatively related to academic self-efficacy only for students in schools with the highest ethnic representation. These findings add complexity to the discussion of how school context matters for Latinx students' academic performance.     

Examining Recruitment Follow-Up Phone Calls and Their Influence on Attendance for Husbands and Wives in a Marriage and Relationship Education Program

Low-income married couples face unique stressors that contribute to increased relationship distress. Federal funding has supported research initiatives aimed at studying how marriage and relationship education (MRE) influences the relationships of low-income married participants. However, research identified recruitment and retention of low-income participants as a major obstacle to the replication of these programs. Therefore, this study examined programmatic data from 786 low-income married participants to investigate how recruitment follow-up influenced attendance in the MRE program. A weak, inverse relationship was found for women between the number of pre-enrollment phone calls made and hours spent in MRE. We found a statistically significant difference between who was contacted (wife, husband, or both) and attendance to the initial intake appointment for program enrollment. Implications and future research are discussed.     

Family Conflict in Childhood and Adolescence and Depressive Symptoms in Emerging Adulthood: Mediation by Disengagement Coping

Exposure to family conflict in childhood increases risk for later life psychological maladjustment. The family environment shapes the development of coping strategies used to manage interpersonal stressors, representing a pathway through which adverse family experiences impact later emotional functioning. In 2 studies, we evaluated engagement and disengagement coping as mediators of the relation between family conflict in childhood and depressive symptoms in young adulthood. Study 1 included participants from continuously married families exposed to higher and lower quality childhood family environments and found that disengagement partially mediated the relation between family conflict and depressive symptoms. Study 2 examined these relations among emerging adults who experienced parental divorce. Results indicated that disengagement coping fully mediated the relation between family conflict and depression. Engagement did not emerge as a mediator in either study. Elevated family conflict across varying family structures might be associated with poor adjustment via disengaged responses to stress.     

The importance of family functioning to prevention of placement: A study of family preservation services

Family preservation services have been found effective in preventing the placement of children outside their homes. Most studies of family preservation services focus on the successful prevention of placement of children in out-of-home care, and relatively few studies have examined how such services affect family functioning. Recent research has begun to examine the relationship between family functioning and prevention of placement. This research has demonstrated improved family functioning for those families who received family preservation services.A version of this paper was first presented at the Sixth National Doctoral Dissertation Symposium, 1993, Ohio State University.     

Cultural and Contextual Influences on Parenting in Mexican American Families

Family stress theory can explain associations between contextual stressors and parenting. The theory, however, has not been tested among Mexican Americans or expanded to include cultural‐contextual risks. This study examined associations between neighborhood, economic, and acculturative stressors and parenting behaviors in a sample of 570 two‐parent Mexican American families. Results support the negative impact of economic stress on parenting through parental depressive symptoms. Neighborhood stress influenced fathers’ depressive symptoms and parenting, but not mothers’. The effects of acculturative stress were inconsistent. Results suggest that contextual stressors common to Mexican American families impact parenting behaviors through parental depression.     

Chronic stressors and daily hassles: unique and interactive relationships with psychological distress

Using daily telephone interviews of a U.S. national sample of adults, aged 25-74 (N = 1,031), the present analyses draw from theories of the stress process and recent research to examine how chronic role-related stressors and daily hassles affect psychological distress. Four separate hypotheses are examined. The first explores the association between chronic stressors and daily hassles. The second tests whether daily hassles function as an intervening variable between chronic stressors and psychological distress. The third tests whether a chronic stressor moderates the relationship between daily hassles and psychological distress. The fourth hypothesis tests for cross-domain effects of chronic stressors and daily hassles. Findings indicate that chronic stressors and daily hassles are distinct types of stressors with unique contributions to psychological distress. The study provides support for chronic home stressors functioning as a moderating factor on the relationship between daily hassles and psychological distress both within and across domains.     

The effects of familial acculturative stress and hopelessness on suicidal ideation by immigration status among college students

Objectives: Based on acculturative family distancing theory, we examined whether familial acculturative stress interacted with hopelessness to predict suicidal ideation differentially among emerging adult immigrant versus nonimmigrant college students. Participants: We recruited 152 generationally and racially/ethnically diverse college students (42 immigrants) from 2012 to 2013. Methods: Participants completed measures of hopelessness, depressive symptoms, ethnic identity, familial acculturative stress, and suicidal ideation. Results: Immigrant status interacted with hopelessness and familial acculturative stress. Hopelessness was associated with less suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score below the 11th percentile, but greater suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score above the 72nd percentile. Conclusions: Familial acculturative stress may exacerbate the effect of hopelessness on suicidal ideation among immigrant college students, and should be monitored during suicide risk assessment and treatment.     

Examining Passive and Active Recruitment Methods for Low-Income Couples in Relationship Education

One of the most difficult aspects of studying low-income couples is the effective implementation of recruitment and retention strategies. Low-income couples face environmental stressors that make participation difficult, and research has yet to identify efficacious methods of recruiting and retaining low-income couples into funded studies. Researchers and practitioners targeting low-income participants rely on a “learn-as-they-go” approach. Therefore, we examined passive and active recruitment strategies for 394 married participants with children under age 18 and reporting a total household income within 200% of the Federal Poverty Guidelines who participated in a federally funded couples and relationship education program. Univariate ANOVAs indicated significant differences between recruitment method and total time spent in couples and relationship education workshops for both women and men. Further, results indicated a relationship exists between recruitment method and the number of follow-up contacts required before participants attended the initial intake appointment. Implications for practice and research are discussed.     

Social well-being in pregnant women: intended versus unintended pregnancies

The relationship between pregnancy intention (unintended versus intended pregnancy) and social well-being was examined in a sample of 72 pregnant, mostly low-income women attending Women, Infants, and Children programs and prenatal clinics in a midwestern community. Feelings of happiness about giving birth and the extent to which having a baby would fill a void in one's life were also examined. Pregnancy intention was significantly associated with reduced social support. Feelings of happiness about having the baby positively correlated with all domains of social support and negatively correlated with loneliness and family relationship problems. The belief that having a baby could fill a void in a woman's life was strongly correlated with perceived loneliness. Interventions to increase social support and to address areas of stress for women whose pregnancies are unintended are recommended. Future research in larger random samples is needed to better test these associations and to make recommendations for specific practice interventions to increase social well-being.     

Predictors of Depression Among Lesbian Women

ABSTRACT

There is a paucity of research on depression and lesbian women. This is surprising given that large numbers of women experience depressive episodes and lesbian women in particular face an increased number of stressors related to their sexual orientation. This study explored how social support from family, social support from friends, relationship involvement, and sexual orientation disclosure related to and predicted depression for a sample of lesbian women. Information from 117 questionnaires was compiled from self-identified lesbians recruited through various lesbian-positive groups and snowball sampling. Results indicated significantly lower depression rates for women who were in a relationship and moderate negative correlations between depression and social support from family, social support from friends, and sexual orientation disclosure. Standard multiple regression analysis showed that 38% of the variability in depression scores was predicted by knowing the scores on the four independent variables. These results suggest that each of the independent variables has a significant effect on level of depression for lesbian women in the sample.     

Effects of community violence exposure and parental mental health on the internalizing problems of urban adolescents

Previous research has documented an association between adolescent community violence exposure (CVE) and poor psychological functioning. The purpose of this study is to delineate the relations of CVE, parental mental health, and adolescent PTSD and depression. Participants consisted of 121 pairs of junior high and high school students and their parents. Adolescents completed measures to assess their history of violence exposure and current psychological functioning. Parents completed a demographic questionnaire and measures assessing their psychological functioning. Hierarchical regression analyses were conducted, and results indicated that, after controlling for demographic variables and family violence exposure, parental mental health emerged as a moderating variable in the relation between CVE and adolescent-rated PTSD, but not in the association between adolescent CVE and depression. Clinical implications of this study and directions for future research are discussed.     

Perceived discrimination and depression among Mexican-origin adults in California

We contend that perceived discrimination has an independent effect on depression outcomes among adults of Mexican origin. Using a sample of 3,012 Mexican-origin respondents in Fresno, California in 1995/96 (ages 18-59) we investigate the direct and moderating connections between perceived discrimination, acculturative stress, and mental health (CES-D). We also investigate the social patterning of perceived discrimination. While more highly acculturated immigrant respondents were more likely to experience discrimination than their less acculturated counterparts, more highly acculturated U.S. born respondents were less likely to experience discrimination. Discrimination was directly related to depression, but this effect was moderated through nativity/country of residence, English-language acculturation, sex, and country of education variables. Moderate levels of legal status acculturative stress were especially depressive for native-born U.S. residents.     

Positively Impacting Maternal Stress and Parental Adjustment through Community-Based Relationship Education (RE)

Relationship education (RE) is a brief, strength-based psychoeducational intervention for couples that demonstrates strong outcomes to decrease individual and couple stress. The current study examined changes in relationship and family adjustment for expectant mothers following RE intervention. Participants included 91 pregnant women (64.8% racial or ethnic minorities) who participated in a community-based RE program. In examination of pre and post-intervention relationship assessment scale and parental stress and coping inventory results, RE intervention contributed to increased relationship satisfaction, and reduced parental distress, as well as to improved social support and family-based support scores among participants. In addition, relationship stress is a major contributor to stress during pregnancy that adds vulnerability for the health of low-income and ethnic minority expectant mothers and their children. Findings indicate the effectiveness of RE to significantly reduce stress for expectant mothers. Therefore, the use of RE as a low-cost and accessible intervention to combat stress provides positive implications for this vulnerable population.     

Characteristics of Couples Who Attend Family Services Counselor Visits in Relationship Education

Case management services for low-income couples receiving relationship education have been required by federal funding agencies. Studies examining relationship education outcomes for low-income couples have yet to address participant characteristics of those who attend case management services (e.g., distressed vs. nondistressed). Thus, this study examined the influence of baseline relationship satisfaction and demographics on attendance at case management visits for 2,628 low-income, partnered participants who attended relationship education. Findings indicated that participants who reported higher baseline relationship distress attended more family services counselor (FSC) visits. However, when we added demographics to the model, relationship distress no longer predicted FSC visits, whereas income served as a predictor for men and women, with those reporting greater monthly income attending more FSC visits.     

Role Conflict and Self‐Efficacy Among Employed Parents: Examining Complex Statistical Interactions

In response to growing concerns with explaining how work and family interfere with each other and with statistical approaches that do not capture the way in which predictors interact, this study tested statistical interactions involving personal and social resources of 410 full‐time employed women and men. The results indicate that self‐efficacy is a strong predictor of family interfering with work (FIW) and work interfering with family (WIF). Gender moderates the relation between supervisor support and WIF moderates the impact of efficacy beliefs and instrumental support at home on FIW. Specifically, while supervisor support is negatively related to WIF in women and men, high levels of support more strongly affected men's perceptions of WIF. In low self‐efficacy men, high levels of support at home improved their perceptions of FIW but these perceptions worsened in women. These findings contrast with earlier research that focus predominantly on the predictive value of structural demands (for example, the number of hours worked per week and family size). This study shows that gender plays a critical yet intricate role as a predictor of the successful management of work and family roles: it is not gender per se but its interaction with personal and social variables that informs us about differences in the experience of employed parents.     

Child care burden and the risk of child maltreatment among low-income working families

Studies suggest that a substantial proportion of low-income working mothers experience work disruptions and parental stress related to child care, which may lead to increases in the risk of physical and psychological abuse and neglect of children. However, little research has examined the relationship between child care burden and the risk of child maltreatment among low-income working families. Using the Fragile Families and Child Wellbeing Study 3-year data, this study explores how child care burden is associated with the risk of child maltreatment (physical aggression, psychological aggression, and neglectful behavior) among low-income working mothers. We find that instability in child care arrangements is likely to increase mothers' physical and psychological aggression, while not having someone reliable for emergency child care is likely to increase mothers' neglectful behaviors. Findings also show that the risk of child maltreatment related to child care burden measures is more significant for single mothers than married mothers. Potential policy implications are discussed.     

Family identification facilitates coping with financial stress: A social identity approach to family financial resilience

Family financial stress research has typically examined negative effects of deprivation on mental health, which in turn erode financial coping. While this work acknowledges family support’s role in buffering these effects, it has typically overlooked how family identification can act to structure the experience of, and response to, economic challenge. We adopt a Social Identity approach, arguing that family identification predicts increased social support and improved well-being, which predicts more effective coping with financial problems. We explore this in two community surveys (N = 369; N = 187). In the first we show that stronger family identification and support predict better well-being, which predicts better evaluation of economic coping. In the second we replicate these findings, and also show that the relationship between well-being and financial distress is fully mediated by perceptions of ‘Collective Family Financial Efficacy’. These findings point to a more positive understanding of how family cohesion can promote mental well-being/resilience.     

The Effects of Trauma on Acculturative Stress

ABSTRACT

There has been an influx of Southeast Asian refugees to the United States over the past 20 years, many of whom have experienced severe trauma. In their new country they face the formidable task of acculturation into a new, unfamiliar culture, often separated from their families and ethnic groups. This study sought to answer the question of whether the severity of trauma endured prior to and during migration affects the level of acculturative stress in a community sample of Cambodian refugees. Two major variables, the experience of trauma and acculturative stress, were examined through a cross-sectional research design which employed multiple regression statistical techniques to analyze the data. The results of the present study established that Cambodian refugees who experienced severe trauma prior to resettlement in the United States had significantly higher levels of acculturative stress than did those with less severe trauma histories.