This paper presents analyses of a representative sample of US Latinos (N=2540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggests a significant association between family cohesion and lower psychological distress and the combination of strong family cohesion with presence of family cultural conflict was associated with higher psychological distress. However, this association differed by Latino groups. We found no association for Puerto Ricans, Cuban results were similar to the aggregate group, family cultural conflict in Mexicans was associated with higher psychological distress, while family cohesion in Other Latinos was associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups.
Objectives-We examined potential pathways by which time in the U.S. may relate to differences in the predicted probability of last year psychiatric disorder among Latino immigrants as compared to U.S.-born Latinos.Methods-We estimated predicted probabilities of psychiatric disorder for U.S.-born and immigrant groups with varying time in the U.S. adjusting for different combinations of covariates. We examined six "pathways" by which time in the U.S. could be associated with psychiatric disorder.Results-Increased time in the U.S. is associated with higher risk of psychiatric disorders among Latino immigrants. After adjustment for covariates, differences in psychiatric disorder rates disappear between U.S.-born and immigrant Latinos. Discrimination and family cultural conflict appear to have a significant role in the association between time in the U.S. and the likelihood of developing psychiatric disorders.Conclusions-Increased perceived discrimination and family cultural conflict are pathways by which acculturation might relate to deterioration of mental health for immigrants. Future studies assessing how these implicit pathways evolve with increased contact with U.S. culture may help to identify strategies for ensuring maintenance of mental health for Latino immigrants.Corresponding author: Benjamin L. Cook, bcook@charesearch.org, Fax. Requests for reprints should be sent to Benjamin Cook, PhD, Cambridge Health Alliance, Center for Multicultural Mental Health Research, 120 Beacon St, 4th Floor, Somerville, MA 02143 (bcook@charesearch.org).Contributors B. Cook originated the study and led the conceptualization, design, and all aspects of writing the article. M. Alegría and J. Lin assisted with the conceptualization and design of the study, and assisted with drafting the article. M. Alegría, J. Lin, and J. Guo contributed to analysis and interpretation of the data. Statistical expertise was provided by J. Lin. All of the authors reviewed drafts and contributed to critical revisions of the article. Human Participant ProtectionThe institutional review boards of the Cambridge Health Alliance, the University of Washington, and the University of Michigan approved all recruitment, consent, and interviewing procedures for the National Latino and Asian American Study. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2010 December 1. Two common patterns have been typically described in the literature: Latino immigrants have better mental health than their U.S.-born counterparts and non-Latino whites despite having disadvantaged socioeconomic status1 -3 (the "immigrant paradox"), and the mental health of immigrants declines over time in the host country 3 (the "acculturation hypothesis"). Our findings from the National Latino and Asian-American Study (NLAAS) on the prevalence of psychiatric disorders among Latinos in the U.S. indicate that foreign nativity is protective for some Latino groups (e.g., Mexicans), but not others (e.g., Puerto Ricans),4 implying that other factor...
Objectives We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of traumatic events (PTEs) among a nationally representative U.S. sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans. Methods PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population. Results Asians have lower prevalence rates of probable lifetime PTSD while African Americans have higher rates as compared to non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared to non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors or differences in types and frequencies of PTEs across groups. Conclusions There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.
The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S. born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys (CPES), a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2532 young adults, ages 21 to 29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relationship between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout.
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