Family, peer, and individual correlates of depressive symptomatology among U.S. and Chinese adolescents

Predicting internalizing problems in Chinese children: the unique and interactive effects of parenting and child temperament

The additive and interactive relations of parenting styles (authoritative and authoritarian parenting) and child temperament (anger/frustration, sadness, and effortful control) to children's internalizing problems were examined in a 3.8-year longitudinal study of 425 Chinese children (aged 6-9 years) from Beijing. At Wave 1, parents self-reported on their parenting styles, and parents and teachers rated child temperament. At Wave 2, parents, teachers, and children rated children's internalizing problems. Structural equation modeling indicated that the main effect of authoritative parenting and the interactions of Authoritarian Parenting × Effortful Control and Authoritative Parenting × Anger/Frustration (parents' reports only) prospectively and uniquely predicted internalizing problems. The above results did not vary by child sex and remained significant after controlling for co-occurring externalizing problems. These findings suggest that (a) children with low effortful control may be particularly susceptible to the adverse effect of authoritarian parenting and (b) the benefit of authoritative parenting may be especially important for children with high anger/frustration.

Perceptions of friendship among youth with distressed friends

This cross-sectional study examined the relationship between a friend's level of internalizing distress and the focal child's perceptions of friendship amongst 5th, 8th, and 11th grade youth. Participants completed the Youth Self-Report to assess internalizing distress and measures assessing perceptions of friendship quality, social support, and self-disclosure within reciprocal, same-sex friendship dyads. Results indicated that youth with friends experiencing low levels of internalizing distress reported poorer friendship quality and decreased levels of social support and self-disclosure within the friendship compared to youth with friends experiencing average or high internalizing distress. In a second set of analyses controlling for the focal child's own internalizing symptoms, gender, and age, friend's level of internalizing distress remained a significant, unique predictor of target participants' self-disclosure about their own problems within the friendship. The findings suggest that a mild degree of internalizing distress may enhance, rather than harm, friendships amongst youth.

Gender differences in adolescent coping behaviors and suicidal ideation: findings from a sample of 73,238 adolescents

Suicide among adolescents is an emerging global public health problem as well as a socioeconomic problem. Stress-coping strategies have been shown to be associated with suicidal ideation. We examined coping behaviors related to suicidal ideation and gender differences in adolescents using the data from the 2010 Korea Youth Risk Behavior Survey (ages 12-19 years; N = 73,238). Logistic regression analysis was used to evaluate associations between suicidal ideation and specific coping behaviors while controlling for potentially confounding variables. In both male and female groups, the coping behavior "drinking alcoholic beverages" and "smoking cigarettes" were positively associated with suicidal ideation. "Watching TV," "playing online/mobile games," and "sleeping" were negatively associated with suicidal ideation in both groups. In males, "engaging in sports" was negatively related to suicidal ideation. In females, "venting by talking to others" and "eating" were negatively related to suicidal ideation. The results indicate that there are gender differences in the effects of coping behaviors on adolescent suicidal ideation, and that developing adaptive coping strategies may function to reduce suicidality. Future studies are needed to examine whether improving coping skills can reduce suicidal ideation in a gender-specific manner.

Genetic and environmental influences on depressive symptoms in Chinese adolescents

Adolescent depression is common and has become a major public health concern in China, yet little research has examined the etiology of depression in Chinese adolescents. In the present study, genetic and environmental influences on Chinese adolescent depressive symptoms were investigated in 1,181 twin pairs residing in Beijing, China (ages 11-19 years). Child- and parent-versions of the children's depression inventory were used to measure adolescents' depressive symptoms. For self-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 50, 5, and 45 % of the variation in depressive symptoms, respectively; for parent-reports, genetic factors, shared environmental factors, and non-shared environmental factors accounted for 51, 18, and 31 % of the variation, respectively. These estimates are generally consistent with previous findings in Western adolescents, supporting the cross-cultural generalizability of etiological model of adolescent depression. Neither qualitative nor quantitative sex differences were found in the etiological model. Future studies are needed to investigate how genes and environments work together (gene-environment interaction, gene-environment correlation) to influence depression in Chinese adolescents.

Child abuse and suicidal ideation among adolescents in China

The present study examined the relationship among physical abuse, psychological abuse, perceived family functioning and adolescent suicidal ideation in Shanghai, China. Perceived family functioning was investigated as a possible moderator between physical abuse, psychological abuse and suicidal ideation. A cross sectional survey using convenience sampling was conducted. A total of 560 valid self-administered questionnaires were completed by the students aged from 12 to 17 in Shanghai. Descriptive statistical analyses, Pearson correlations analyses, and hierarchical regression analyses were adopted as methods of data analyses. Results indicated that physical abuse was significantly associated with greater adolescent suicidal ideation, while a higher level of perceived family functioning was significantly associated with lower suicidal ideation. However, psychological abuse was not associated with suicidal ideation. Perceived family functioning was shown to be a moderator between physical abuse and suicidal ideation. Specifically, mutuality and family communication moderated the relationship between physical abuse and suicidal ideation. To decrease adolescent suicidal ideation, measures are suggested to prevent physical abuse and enhance family functioning. First, it is important to increase the parents' awareness of the meaning and boundaries of physical abuse, as well as the role it plays in contributing to adolescent suicidal ideation. Second, parents should be taught appropriate parenting skills and knowledge and be guided to treat the children as individuals with their unique personality, rights and privileges. Third, it is important to promote family harmony, effective communication as well as mutual trust, concern and understanding among family members.

The relationship of family characteristics and bipolar disorder using causal-pie models

Many family characteristics were reported to increase the risk of bipolar disorder (BPD). The development of BPD may be mediated through different pathways, involving diverse risk factor profiles. We evaluated the associations of family characteristics to build influential causal-pie models to estimate their contributions on the risk of developing BPD at the population level. We recruited 329 clinically diagnosed BPD patients and 202 healthy controls to collect information in parental psychopathology, parent-child relationship, and conflict within family. Other than logistic regression models, we applied causal-pie models to identify pathways involved with different family factors for BPD. The risk of BPD was significantly increased with parental depression, neurosis, anxiety, paternal substance use problems, and poor relationship with parents. Having a depressed mother further predicted early onset of BPD. Additionally, a greater risk for BPD was observed with higher numbers of paternal/maternal psychopathologies. Three significant risk profiles were identified for BPD, including paternal substance use problems (73.0%), maternal depression (17.6%), and through poor relationship with parents and conflict within the family (6.3%). Our findings demonstrate that different aspects of family characteristics elicit negative impacts on bipolar illness, which can be utilized to target specific factors to design and employ efficient intervention programs.

Positive daily family interactions eliminate gender differences in internalizing symptoms among adolescents

By the age of 18, girls are more than twice as likely as boys to experience internalizing symptoms. Focusing upon the family, a significant factor for adolescent mental health, we examined how positive and negative daily family interactions relate to gender differences in internalizing symptoms. 681 12th grade students (54 % female) completed diary checklists each night for 2 weeks in which they indicated whether they got along with their family (positive family interactions) and argued with their family (negative family interactions). Results indicate that negative daily family interactions explain, in part, why females experience heightened internalizing symptoms. Yet, even in the face of negative family interactions, positive daily family interactions have salutatory effects, reducing females' emotional distress and eliminating gender differences in internalizing symptoms at high levels of positive interactions. These findings underscore the importance of positive family interactions for adolescent girls' mental health.

PERSONALITY PREDISPOSITIONS IN CHINESE ADOLESCENTS: THE RELATION BETWEEN SELF-CRITICISM, DEPENDENCY, AND PROSPECTIVE INTERNALIZING SYMPTOMS

The present study examined the prospective relation between two personality predispositions, self-criticism and dependency, and internalizing symptoms. Specifically, it was examined whether self-criticism and dependency predicted symptoms of depression and social anxiety, and if a moderation (e.g. diathesis-stress) or mediation model best explained the relation between the personality predispositions and emotional distress in Chinese adolescents. Participants included 1,150 adolescents (597 females and 553 males) from mainland China. Participants completed self-report measures of self-criticism, dependency, and neuroticism at baseline, and self-report measures of negative events, depressive symptoms, and social anxiety symptoms once a month for six months. Findings showed that self-criticism predicted depressive symptoms, while dependency predicted social anxiety symptoms. In addition, support was found for a mediation model, as opposed to a moderation model, with achievement stressors mediating the relation between self-criticism and depressive symptoms. Overall, these findings highlight new developmental pathways for the development of depression and social anxiety symptoms in mainland Chinese adolescents. Implications for cross-cultural developmental psychopathology research are discussed.

Family influences on the long term post-disaster recovery of Puerto Rican youth

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

Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models

The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha and 592 adolescents (287 female, 305 male) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular 1-month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents.

Chinese American adolescents: perceived parenting styles and adolescents' psychosocial health

BACKGROUND

Asian Americans are one of the fastest-growing minority groups in the USA, and Chinese constitute the largest group. Evidence suggests that Asian American adolescents experience higher levels of depressive symptoms than their same-gender white counterparts. Quantitative findings suggest associations between parenting factors and Chinese American adolescents' mental health. A qualitative understanding regarding Chinese American adolescents' perceived parenting styles and its relationship with adolescents' psychosocial health is warranted.

AIM

To gain an in-depth understanding of Chinese American adolescents' perceived parenting styles and how parenting styles might influence adolescents' psychosocial health.

METHODS

In this qualitative study, we recruited 15 Chinese American adolescents aged 12-17 years in a southwest metropolitan area. We conducted two focus group interviews. Participants also filled out a brief questionnaire that included their socio-demographic information, immigration history and level of acculturation.

RESULTS

Participants reported perceiving that parents had high expectations about academic performance and moral values. They also perceived stricter family rules regarding choices of friends compared with their non-Asian peers. Parents tended to be more protective of girls than of boys. Both Chinese American boys and girls reported poor or ineffective communication with their parents, which contributed to increased conflict between parents and adolescents and emotional distress of the adolescents.

CONCLUSIONS

The findings provide evidence for nurses to develop linguistically and culturally tailored resources (e.g. parent support groups, programs aimed to improving parent-child communication) or connect these families with existing resources to enhance parenting skills and consequently reduce emotional distress of their adolescent children.

Reliability and validity of the Center for Epidemiological Studies Depression Scale in 2 special adult samples from rural China

Few studies on the validation of the Center for Epidemiological Studies Depression Scale (CES-D) in Chinese have been conducted in the samples from rural area, whereas the mental health problems among rural Chinese deserve more attention. For instance, the suicide rate in rural China is about 3 times that of the urban rate. This study aimed at assessing reliability and validity of the CES-D in 2 special adult samples in rural China, with data obtained by face-to-face interviews. One sample consisted of the proxy informants for subjects who committed suicide, and the other was of the proxy informants for living controls. For each person who committed suicide and each control, a family member and close friend served as informants. This study focused on informants themselves (not the persons who committed suicide or the living control himself/herself). Suicide informants (n = 781) who had experienced the suicide of a relative or close friend in the past 6 months were compared with the control informants (n = 832) who had no such experience. Internal reliability was satisfactory (Cronbach coefficients were .949 for suicide informants and .880 for control informants). Good concurrent validity and criterion validity were found by analyzing the relations to negative life events and the Scale for Suicide Ideation. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) had good fit in rural Chinese. These findings suggested that the CES-D had good reliability and validity when applied in these 2 adult samples in rural China. Factor structure analyses of the CES-D indicated that "somatization" process of expressing depressive symptoms still existed among rural Chinese.

Interacting effect of BDNF Val66Met polymorphism and stressful life events on adolescent depression

There is a strong etiological link between brain-derived neurotrophic factor and depression, but the neurocellular mechanisms and gene-environment interactions remain obscure. This study investigated whether one functional polymorphism in the brain-derived neurotrophic factor gene (BDNF Val66Met) modulates the influence of stressful life events on adolescent depressive symptoms. A total of 780 pairs of ethnic Han Chinese adolescent twins, 11-17 years of age, were randomly assigned to one of two subgroups (twin1 and twin2). All subjects were genotyped as Val/Val, Val/Met or Met/Met, and assessed for depressive symptoms using the Children's Depression Inventory. The level of environmental stress was estimated by the frequency of stressful life events using the Life Events Checklist. The frequency of stressful life events was significantly correlated with depressive symptoms (twin1: β = 0.21, P = 0.01; twin2: β = 0.27, P < 0.01), but there was no significant main effect of the BDNF Val66Met genotype on depressive symptoms. In both subgroups, however, the interaction between the BDNF Val66Met genotype and stressful life event frequency was significant (twin1: β = 0.19, P = 0.01; twin2: β = 0.15, P = 0.04); individuals with one or two Val alleles demonstrated a greater susceptibility to both the detrimental effects of higher stress and the beneficial effects of lower stress compared to the Met/Met genotype. These findings support the 'differential-susceptibility' hypothesis, whereby the BDNF Val allele modulates the influence of environmental stress on depression by enhancing the neuroplastic response to all life events.

Depression in China: integrating developmental psychopathology and cultural-clinical psychology

With a starting point in John Abela's groundbreaking developmental psychopathology research on adolescent depression in China, we aimed to review the state of the literature on Chinese depression across the lifespan. We began with Dr. Abela's published studies relevant to depression in China and our own research with adults before turning to the reference lists of these articles to find additional sources. Then we conducted literature searches using PsycINFO and PubMed to find other relevant studies published between April 2001 and April 2011 . There are two distinct literatures on depression in China. Developmental psychopathology research has emphasized adolescent samples and cognitive models of causation; cultural-clinical psychology and cultural psychiatry research have emphasized adult samples and the meanings associated with emotions, symptoms, and syndromes. Both approaches to the study of depression in China have yielded important findings but have also highlighted issues that could be better addressed by incorporating the other approach. Beyond depression in China, the psychological study of culture and mental health more generally would benefit from greater exchange between developmental psychopathology and cultural-clinical psychology.

Longitudinal linkages among parent-child acculturation discrepancy, parenting, parent-child sense of alienation, and adolescent adjustment in Chinese immigrant families

Parent-child acculturation discrepancy is a risk factor in the development of children in immigrant families. Using a longitudinal sample of Chinese immigrant families, the authors of the current study examined how unsupportive parenting and parent-child sense of alienation sequentially mediate the relationship between parent-child acculturation discrepancy and child adjustment during early and middle adolescence. Acculturation discrepancy scores were created using multilevel modeling to take into account the interdependence among family members. Structural equation models showed that during early adolescence, parent-child American orientation discrepancy is related to parents' use of unsupportive parenting practices; parents' use of unsupportive parenting is related to increased sense of alienation between parents and children, which in turn is related to more depressive symptoms and lower academic performance in Chinese American adolescents. These patterns of negative adjustment established in early adolescence persist into middle adolescence. This mediating effect is more apparent among father-adolescent dyads than among mother-adolescent dyads. In contrast, parent-child Chinese orientation discrepancy does not demonstrate a significant direct or indirect effect on adolescent adjustment, either concurrently or longitudinally. The current findings suggest that during early adolescence, children are more susceptible to the negative effects of parent-child acculturation discrepancy; they also underscore the importance of fathering in Chinese immigrant families.

Parents’ Expression and Discussion of Emotion in the Multilingual Family

Parents regularly use words to express and discuss emotion with their children, but does it matter which language they use to do so? In this article, we examine this question in the multilingual family context by integrating findings from both psychological and linguistic research. We propose that parents’ use of different languages for emotional expression or discussion holds significant implications for children’s emotional experience, understanding, and regulation. Finally, we suggest that an understanding of the implications of emotion-related language shifts is critical, particularly in adapting interventions within a rapidly diversifying society.

A developmental-contextual model of depressive symptoms in Mexican-origin female adolescents

The current study tested a developmental-contextual model of depressive symptomatology among Mexican-origin, female early and middle adolescents and their mothers. The final sample comprised 271 dyads. We examined the interrelations among cultural (i.e., acculturation dissonance), developmental (i.e., pubertal development and autonomy expectation discrepancies), and interpersonal (i.e., mother-daughter conflict and maternal supportive parenting) factors in predicting adolescents' depressive symptoms. For both early and middle adolescents, maternal support was negatively associated with mother-daughter conflict and depressive symptoms. Mother-daughter autonomy expectation discrepancies were positively associated with mother-daughter conflict, but this association was found only among early adolescents. Further, mother-daughter acculturation dissonance was positively associated with mother-daughter conflict but only among middle adolescents. Findings call for concurrently examining the interface of developmental, relational, and cultural factors in predicting female adolescents' depressive symptomatology and the potential differences by developmental stage (e.g., early vs. middle adolescence).

Depression symptoms among Omani children: age and sex differences

The present study explored the existence of depressive symptoms among Omani children according to sex and age. The Arabic translated version of the Multidimensional Child and Adolescent Depression Scale was administered to 1,749 children (828 boys, 921 girls) ranging in age from 10 to 18 years old (M= 13.9, SD = 2.3) from 10 schools representing different areas of Muscat, Oman. The results showed no differences in the total mean scores on depression between boys and girls, although differences were observed on 4 of the 8 subscales. Boys had significantly higher scores on Weak concentration and Loneliness, while girls scored higher for Sleep problems and Anhedonia. Significant differences across ages also were exhibited for the total score as well as four subscales (Pessimism, Weak concentration, Anhedonia, and Fatigue), suggesting higher rates of depression among 15- to 18-year-olds.

Contributions of dopamine-related genes and environmental factors to highly sensitive personality: a multi-step neuronal system-level approach

Traditional behavioral genetic studies (e.g., twin, adoption studies) have shown that human personality has moderate to high heritability, but recent molecular behavioral genetic studies have failed to identify quantitative trait loci (QTL) with consistent effects. The current study adopted a multi-step approach (ANOVA followed by multiple regression and permutation) to assess the cumulative effects of multiple QTLs. Using a system-level (dopamine system) genetic approach, we investigated a personality trait deeply rooted in the nervous system (the Highly Sensitive Personality, HSP). 480 healthy Chinese college students were given the HSP scale and genotyped for 98 representative polymorphisms in all major dopamine neurotransmitter genes. In addition, two environment factors (stressful life events and parental warmth) that have been implicated for their contributions to personality development were included to investigate their relative contributions as compared to genetic factors. In Step 1, using ANOVA, we identified 10 polymorphisms that made statistically significant contributions to HSP. In Step 2, these polymorphism's main effects and interactions were assessed using multiple regression. This model accounted for 15% of the variance of HSP (p<0.001). Recent stressful life events accounted for an additional 2% of the variance. Finally, permutation analyses ascertained the probability of obtaining these findings by chance to be very low, p ranging from 0.001 to 0.006. Dividing these loci by the subsystems of dopamine synthesis, degradation/transport, receptor and modulation, we found that the modulation and receptor subsystems made the most significant contribution to HSP. The results of this study demonstrate the utility of a multi-step neuronal system-level approach in assessing genetic contributions to individual differences in human behavior. It can potentially bridge the gap between the high heritability estimates based on traditional behavioral genetics and the lack of reproducible genetic effects observed currently from molecular genetic studies.

Family Correlates of Adjustment Profiles in Mexican-Origin Female Adolescents

This study used a person-centered approach to examine patterns of adjustment along psychological (i.e., depression, self-esteem, anxiety) and academic (i.e., academic motivation) domains in a sample (N = 338) of Mexican-origin female adolescents. Four adjustment profiles were identified. A High Functioning (n = 173) group, which exhibited high positive adjustment and academic functioning, an Average Functioning (n = 83) group, who exhibited average psychological and academic functioning, an Academically Oriented and Stressed (n = 19) group, who exhibited high academic motivation, but poor psychological functioning in anxiety and negative affect, and a Low Functioning" (n = 25) group, who exhibited poor adjustment overall. Further, paternal and maternal parenting characteristics (i.e., autonomy granting, parent-adolescent conflict, and supportive parenting) were differentially related to Mexican-origin female adolescents' profiles, providing further evidence for the existence of the profiles. Results contribute to the current literature on Latino adolescents and highlight the importance of examining psychological and academic domains concurrently to determine how these two domains of adjustment are linked among this population.

Intergenerational acculturation conflict and Korean American parents' depression symptoms

This study examined the links between intergenerational acculturation conflict and depression symptoms in 176 Korean American parents of children between the ages of 5 and 10. Approximately, 29% of fathers and 28% of mothers reported increased depression symptoms, which were related to parent-child acculturation conflict. Specific situations related to parental depression symptoms included conflicts over the child's social life, comparing the child with others, expressions of love, the importance of saving face, and proper Korean child's behavior. These findings can be used to develop a family intervention program to decrease parental depression symptoms by reducing parent-child acculturation conflict.

The impact of stress on depressive symptoms is moderated by social support in Chinese adolescents with subthreshold depression: a multi-wave longitudinal study

BACKGROUND

Most studies have shown that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in adolescents with subthreshold depression. Thus, the current study examined whether high levels of social support from peers buffer adolescents exhibiting subthreshold depressive symptoms against experiencing further increases in such symptoms following the occurrence of negative events.

METHODS

Participants included 143 adolescents (aged 14 to 18; M=16.07, SD=.66) in Hunan Province China who were selected because they were exhibiting subthreshold depressive symptoms at the time of initial assessment. During an initial assessment, participants completed measures assessing social support from peers and depressive symptoms. Participants subsequently completed measures assessing depressive symptoms and the occurrence of negative events once every three months for the subsequent fifteen months.

RESULTS

The prevalence of lifetime subthreshold depression in Hunan was 22.9% (n=143). The results of hierarchical linear modeling analyses indicated that lower levels of social support from peers was associated with greater increases in depressive symptoms following the occurrence of negative events.

CONCLUSIONS

The results suggested that the association between the occurrence of negative events and increased depressive symptoms is moderated by social support from peers in adolescents with subthreshold depression in mainland China, in line with the buffering hypothesis.

LIMITATIONS

The adolescent sample used in the current study was from Hunan, China, which could limit the generalizability of our results to other populations. In addition, given that it is possible that cultural context shapes symptom manifestation, future research should assess a broader array of symptom outcomes.

Understanding the effect of social capital on the depression of urban Chinese adolescents: an integrative framework

Using data from an ongoing longitudinal study of 5,164 adolescents and their parents from seven cities in mainland China, this study investigated how social capital embedded in the family and the community, together with family human capital and financial capital, influenced the depressive symptoms of urban Chinese adolescents within an integrative framework. The structural equation modeling results suggested that higher community social capital was associated with lower level of adolescent depressive symptoms and was the strongest predictor among all these contextual factors. Family social capital played a significant role in mediating the effects of all other contextual factors on adolescent depressive symptoms. Unexpectedly, higher family financial capital predicted increased depressive symptoms both directly and indirectly through its negative effect on family social capital. As for gender, female adolescents reported more depressive symptoms as a result of less available family social capital. Implications of these findings for theory, practice, policy, and future research are discussed.

The CES-D in Chinese American women: construct validity, diagnostic validity for major depression, and cultural response bias

Previous studies of the Center for Epidemiologic Studies Depression Scale (CES-D) in Chinese Americans describe internal reliability and factor structure. We report CES-D construct validity and diagnostic validity for major depression in a probability sample of 168 community-dwelling Chinese American women. Internal consistency was satisfactory (Cronbach's alpha=0.86). Good construct validity was indicated by significantly higher mean CES-D scores for respondents who reported lower social support, worse self-perceived general health, or stressful life events, including intimate partner violence. Cultural response bias was found, with positively-stated CES-D items (e.g. "I was happy") producing higher depression scores in immigrants and subjects who preferred to speak Chinese. Diagnostic validity for major depression was assessed using the Composite International Diagnostic Interview. A CES-D cut-off score of 16 had sensitivity of 100% (95% CI: 44% to 100%), specificity of 76% (95% CI: 69% to 82%), PPV of 7% (95% CI: 3% to 19%) and NPV of 100% (95% CI: 97% to 100%). Our findings suggest that the CES-D is useful for screening out non-depressed subjects in a first-stage assessment. However, it should be followed by a diagnostic tool in Chinese American women with scores above the cut-off in order to identify those with clinical depression.

Perceived social support, hope, and quality of life of persons living with HIV/AIDS: a case study from Nepal

PURPOSE

This study investigates the relationship among perceived satisfaction from social support, hope, and QOL of PLWHA.

METHOD

A cross-sectional in design was applied, among a sample of 160 HIV-infected persons receiving treatment, care, and support from eight community-based NGOs. QOL was assessed using the WHO (QOL)-26 tool, and social support was assessed by use of a modified Sarason's Social Support Questionnaire. A Hope Assessment Scale was also developed.

RESULTS

The non-family support network was greater than family support network. Overall satisfaction from social support and hope was significantly correlated with QOL; the greatest effect of social support was on environmental functioning, and the lowest was on social relationships, emotional support was less a predictor of social relationship than other types of supports.

CONCLUSION

The effect of perceived satisfaction from social support was through the mediation variable hope. As it has widely been recognized that community-based support is vital for issues of quality of life, strategies to improve social support and hope intervention programs are strongly encouraged. The results of the study have implications for providing care, treatment, and psycho-social support to maintain or enhance quality of life of PLWHA.

The relationship between interparental conflict and adolescents’ affective well-being: Mediation of cognitive appraisals and moderation of peer status

This study examined the mediation effect of cognitive appraisals and the moderation role of peer status in the association between interparental conflict and adolescents’ affective well-being based on a sample of 549 Chinese adolescents from 7th to 12th grades. Interparental conflict properties, adolescents’ cognitive appraisals of conflict, affective well-being, and peer status were measured through scales and peer nomination surveys. The results of structure equation modeling showed that: cognitive appraisals totally mediated the association between marital conflict and adolescents’ affective well-being; peer status moderated the effect of marital conflict on adolescents’ positive affect but not on negative affect; and the relationship between marital conflict and positive affect showed different patterns for adolescents of different social status. Therefore, to better understand affective well-being of adolescents from high marital conflict families, their cognitive appraisals of conflict and peer relations should be taken into account.

Health risks for older US adolescents in foster care: the significance of important others' health behaviours on youths' health and health behaviours

BACKGROUND

Little research to date has examined older foster care youths' physical health and the associated health behaviours of the youth and important people in their lives (parents, peers and important non-parental adults).

METHODS

Older US foster care youth (n= 188) completed surveys on multiple indicators of self-report physical health, including number of chronic health problems, overall health and sick symptoms, as well as their own health-compromising behaviours and the health-compromising behaviours of important others.

RESULTS

The findings suggested that boys, particularly those placed in non-kin foster homes and group homes, appeared to have poorer health than did boys in these placement settings. Girls, however, engaged in similar levels of health-compromising behaviours as boys. Furthermore, the health-compromising behaviours of peers and important non-parental adults (VIPs), but not parents, were associated with youths' health behaviours, which, in turn, were associated with the physical health status of the foster care youth.

CONCLUSION

Youth report high levels of health-related problems and involvement in health-compromising behaviours. Healthcare practitioners can help to improve the health and well-being of children in foster care by becoming informed about adolescent health behaviours, as well as the health behaviours of their peers and other important non-parental adults.

Fathers' parenting, adverse life events, and adolescents' emotional and eating disorder symptoms: the role of emotion regulation

PURPOSE

To investigate the role of emotion regulation in the relation between fathers' parenting (specifically warmth, behavioral control and psychological control) and adolescents' emotional and eating disorder symptoms, after adjustment for controls.

METHODS

A total of 203 11-18 year-old students from a school in a socio-economically disadvantaged area in North-East London completed questionnaires assessing emotional symptoms (measured with the Strengths and Difficulties Questionnaire's (SDQ) Emotional Symptoms Scale), eating disorder symptoms (measured with the Eating Attitudes Test (EAT-26)), difficulties in emotion regulation (measured with the Difficulties in Emotion Regulation Scale (DERS)), and fathers' overprotection and warmth, measured with the Parental Bonding Instrument (PBI), as well as behavioral and psychological control. The confounding variables considered were number of proximal (i.e., during the last year) adverse life events experienced, gender, age, and socio-economic status (eligibility for free school meals).

RESULTS

Adolescents' difficulties in emotion regulation mediated the link between fathers' psychological control and adolescents' emotional symptoms, but not the link between fathers' parenting and adolescents' eating disorder symptoms, which appeared to be more directly linked to fathers' psychological control and number of proximal adverse life events experienced. Proximal adverse life events experienced were also strongly associated with difficulties in emotion regulation.

CONCLUSIONS

The study findings have implications for intervention programs which may prove more fruitful in addressing adolescent emotional problems by targeting underlying emotion regulation abilities, and in addressing adolescent eating disorder symptoms by protecting adolescents with a recent experience of multiple adverse life events. Parenting programs also stand to benefit from the evidence presented in this study that paternal psychological control may have uniquely harmful consequences for adolescent development through the hampering or atrophying of emotion regulation abilities and the encouragement of eating disorders.

A preliminary study of daily interpersonal stress and C-reactive protein levels among adolescents from Latin American and European backgrounds

OBJECTIVE

To examine the association between the experience of daily interpersonal stress and levels of C-reactive protein (CRP), an inflammatory marker that is a key indicator of cardiovascular risk, during the teenage years.

METHODS

A total of 69 adolescents (Mage= 17.78 years) completed daily diary checklists each night for 14 days in which they reported their experience of negative interpersonal interactions in the domains of family, peers, and school (e.g., conflict with family and friends, peer harassment, punishment by parents and teachers). Blood samples were obtained an average of 8.63 months later and assayed for circulating levels of CRP, using enzyme-linked immunosorbent assay. Measures of body mass index (BMI), socioeconomic status (SES), substance use, stressful life events, rejection sensitivity, and psychological distress were obtained.

RESULTS

A greater frequency of daily interpersonal stress was associated with higher levels of CRP, even after controlling for BMI, SES, substance use, life events, rejection sensitivity, psychological distress, and frequency of daily interpersonal stress 2 years earlier.

CONCLUSIONS

Experiencing a high frequency of interpersonal stressors that are typical of adolescent life is associated with higher levels of inflammation even among a normative, healthy sample of adolescents. Additional work should focus on other daily experiences during the adolescent period and their implications for elevated risk for later cardiovascular disease.

Relations of parenting style to Chinese children's effortful control, ego resilience, and maladjustment

The purpose of the study was to examine the relations of authoritative parenting and corporal punishment to Chinese first and second graders' effortful control (EC), impulsivity, ego resilience, and maladjustment, as well as mediating relations. A parent and teacher reported on children's EC, impulsivity, and ego resilience; parents reported on children's internalizing symptoms and their own parenting, and teachers and peers reported on children's externalizing symptoms. Authoritative parenting and low corporal punishment predicted high EC, and EC mediated the relation between parenting and externalizing problems. In addition, impulsivity mediated the relation of corporal punishment to externalizing problems. The relation of parenting to children's ego resilience was mediated by EC and/or impulsivity, and ego resilience mediated the relations of EC and impulsivity to internalizing problems.

Depressive symptoms in Chinese children and adolescents: parent, teacher, and self reports

BACKGROUND

Most studies of depressive symptoms in children and adolescents have been conducted in Western countries. This study was designed to examine depressive symptoms and age and gender differences in children and adolescents in China.

METHODS

Participants consisted of two community samples of children and adolescents (n1=4858, n2=1362) in Shandong, China. Child Behavior Checklist (CBCL), Teacher Report Form (TRF) and Youth Self Report (YSR) were used to assess depressive symptoms.

RESULTS

Using American norms, the prevalence rates of depression in Chinese children and adolescents were 5.9% with self report, 0.9% with parent report, and 0.8% with teacher report. Self and teacher-reported depressive symptoms were significantly increased with age for both boys and girls. Compared with American norms, self-reported depressive scores were significantly higher in Chinese adolescents, while parent and teacher-reported scores were significantly lower in Chinese children.

LIMITATIONS

Our study lacks clinical assessment of depressive symptoms and the study is comprised of two separate samples where parent and teacher reports and youth reports could not be compared directly.

CONCLUSIONS

The prevalence of self-reported depressive symptoms in Chinese children and adolescents are much higher than those reported by either parents or teachers. Depressive symptoms are increased with age but do not differ between boys and girls.

Korean American adolescent depression and parenting

PROBLEM

Korean American adolescents tend to experience more mental health problems than adolescents in other ethnic groups.

METHODS

The goal of this study was to examine the association between Korean American parent-adolescent relationships and adolescents' depressive symptoms in 56 families.

FINDINGS

Thirty-nine percent of adolescents reported elevated depressive symptoms. Adolescents' perceived low maternal warmth and higher intergenerational acculturation conflicts with fathers were significant predictors for adolescent depressive symptoms.

CONCLUSIONS

The findings can be used to develop a family intervention program, the aim of which would be to decrease adolescent depressive symptoms by promoting parental warmth and decreasing parent-adolescent acculturation conflicts.

Relations of parenting and temperament to Chinese children's experience of negative life events, coping efficacy, and externalizing problems

The relations of parenting and temperament (effortful control and anger/frustration) to children's externalizing problems were examined in a 3.8-year longitudinal study of 425 native Chinese children (6-9 years) from Beijing. Children's experience of negative life events and coping efficacy were examined as mediators in the parenting- and temperament-externalizing relations. Parents reported on their own parenting. Parents and teachers rated temperament. Children reported on negative life events and coping efficacy. Parents, teachers, children, or peers rated children's externalizing problems. Authoritative and authoritarian parenting and anger/frustration uniquely predicted externalizing problems. The relation between authoritarian parenting and externalizing was mediated by children's coping efficacy and negative school events. The results suggest there is some cross-cultural universality in the developmental pathways for externalizing problems.

Expanding acculturation theory: Are acculturation models and the adaptiveness of acculturation strategies generalizable in a colonial context?

Most acculturation research has been conducted in immigrant settings. The present study examined the generalizability of acculturation models and the adaptiveness of acculturation strategies in another bicultural environment — a colonial setting. The sample included 138 girls ( M = 13.8 years) and their parents from Hong Kong, a former British colony. Results verified that both Chinese and western acculturation occurred on individual psychological levels and that the bidimensional model was a suitable acculturation framework. Using hierarchical multiple regression, results suggested that acculturation towards Chinese (majority) culture was related to better adaptation in terms of higher academic achievement and positive family dynamics (parental nurturance and closer family relationships). Acculturation towards western (minority) culture was related to poorer adaptation in terms of engaging in greater misconduct and negative family interactions (larger intergenerational value discrepancies and family conflicts). Thus, acculturation towards the majority culture held adaptive implications, whereas acculturation towards the minority culture held maladaptive implications. Consideration of the bicultural composition (e.g., status, prestige, strength of cultural networks of each culture) should be incorporated into acculturation theory to better understand adjustment implications across a wide range of contexts.

Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults

Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults.

A Gender-Moderated Model of Family Relationships and Adolescent Adjustment

The objective of this study was to explain why adolescent girls with conduct problems (CP) are more at risk than boys to develop emotional distress (ED) in a sample composed of Israeli-born and immigrant youth from Ethiopia and the former Soviet Union (n = 305, ages 14-18). We tested a structural equation model and found a very good fit to the data for both immigrant and nonimmigrant groups. The hypothesized effects of gender, CP, and parent-child relationships on ED were significant, whereas the effect of family discord was mediated by parent-child relationships. Subsequently, we used multiple-group analyses to test the two interaction hypotheses. We found significantly higher associations between CP and family discord and between ED and negative parent-child relationships in girls compared to boys.

Intergenerational discrepancies of parental control among Chinese American families: Links to family conflict and adolescent depressive symptoms

This study investigated how discrepancies between adolescents' and parents' endorsement of parental control contribute to adolescent depressive symptoms. Family conflict was hypothesized to mediate the link between parent-adolescent discrepancies and depressive symptoms. The sample consisted of 166 pairs of Chinese American adolescents and their parents. The results indicated that, as predicted, greater discrepancies between adolescents and their parents on parental control related to greater adolescent depressive symptoms. Furthermore, adolescent's perceived degree of family conflict partially mediated this relation. Both parents and adolescents are changing and adapting to their cultural contexts; some in synchrony and some not. Identifying areas where parents and adolescents diverge concerning values, behaviors, and beliefs, is an important avenue to understanding Chinese American adolescents' mental health.

Major depression in Chinese Americans: the roles of stress, vulnerability, and acculturation

BACKGROUND

This study examined the relationship between recent negative life events, level of acculturation and other psychosocial risk factors in predicting major depression in Chinese Americans.

METHOD

Data were collected on 1,747 Chinese immigrants and native-born residents of the United States (ages 18-65) who resided in Los Angeles County between 1993 and 1994.

RESULTS

Findings indicated that a positive psychiatric history increased risk for major depression at Time 2, while social conflicts and traumatic life events moderated the effects of negative life events in increasing risk for major depression. In addition, level of acculturation moderated the effects of recent negative events in increasing risk, but only for those who were more highly acculturated.

CONCLUSIONS

The importance of testing the cross-cultural applicability of the stress-vulnerability hypothesis among ethnic minorities and extending them to include immigrant vulnerabilities is discussed.

Correlates of depressive symptoms among Latino and Non-Latino White adolescents: findings from the 2003 California Health Interview Survey

BACKGROUND

The prevalence of depression is increasing not only among adults, but also among adolescents. Several risk factors for depression in youth have been identified, including female gender, increasing age, lower socio-economic status, and Latino ethnic background. The literature is divided regarding the role of acculturation as risk factor among Latino youth. We analyzed the correlates of depressive symptoms among Latino and Non-Latino White adolescents residing in California with a special focus on acculturation.

METHODS

We performed an analysis of the adolescent sample of the 2003 California Health Interview Survey, which included 3,196 telephone-interviews with Latino and Non-Latino White adolescents between the ages of 12 and 17. Depressive symptomatology was measured with a reduced version of the Center for Epidemiologic Studies Depression Scale. Acculturation was measured by a score based on language in which the interview was conducted, language(s) spoken at home, place of birth, number of years lived in the United States, and citizenship status of the adolescent and both of his/her parents, using canonical principal component analysis. Other variables used in the analysis were: support provided by adults at school and at home, age of the adolescent, gender, socio-economic status, and household type (two parent or one parent household).

RESULTS

Unadjusted analysis suggested that the risk of depressive symptoms was twice as high among Latinos as compared to Non-Latino Whites (10.5% versus 5.5 %, p < 0.001). The risk was slightly higher in the low acculturation group than in the high acculturation group (13.1% versus 9.7%, p = 0.12). Similarly, low acculturation was associated with an increased risk of depressive symptoms in multivariate analysis within the Latino subsample (OR 1.54, CI 0.97-2.44, p = 0.07). Latino ethnicity emerged as risk factor for depressive symptoms among the strata with higher income and high support at home and at school. In the disadvantaged subgroups (higher poverty, low support at home and at school) Non-Latino Whites and Latinos had a similar risk of depressive symptoms.

CONCLUSION

Our findings suggest that the differences in depressive symptoms between Non-Latino Whites and Latino adolescents disappear at least in some strata after adjusting for socio-demographic and social support variables.

Relations of effortful control, reactive undercontrol, and anger to Chinese children's adjustment

The purpose of the study was to examine the zero-order and unique relations of effortful attentional and behavioral regulation, reactive impulsivity, and anger/frustration to Chinese first and second graders' internalizing and externalizing symptoms, as well as the prediction of adjustment from the interaction of anger/frustration and effortful control or impulsivity. A parent and teacher reported on children's anger/frustration, effortful control, and impulsivity. Parents reported on children's internalizing symptoms, and teachers and peers reported on children's externalizing symptoms. Children were classified as relatively high on externalizing (or comorbid), internalizing, or nondisordered. High impulsivity and teacher-reported anger/frustration, and low effortful control, were associated with externalizing problems, whereas low effortful control and high parent-reported anger were predictive of internalizing problems. Unique prediction from effortful and reactive control was obtained and these predictors (especially when reported by teachers) often interacted with anger/frustration when predicting problem behavior classification.