The Spanish translation and cultural adaptation of the Diagnostic Interview Schedule for Children (DISC) in Puerto Rico

The Development of Shyness from Late Childhood to Adolescence: A Longitudinal Study of Mexican-origin Youth

Shyness, the tendency to be inhibited and uncomfortable in novel social situations, is a consequential personality trait, especially during adolescence. The present study examined the development of shyness from late childhood (age 10) through adolescence (age 16) using data from a large, longitudinal study of Mexican-origin youth (N = 674). Using both self- and mother-reports of shyness assessed via the Early Adolescent Temperament Questionnaire-Revised, we found moderate to high rank-order stabilities across two-year intervals and a mean-level decrease in shyness from age 10 to 16. Anxiety and depression were associated with higher initial levels of shyness, and anxiety was associated with greater decreases in shyness from age 10 to 16. Contrary to predictions, neither nativity (country of birth) nor language proficiency (English, Spanish) was associated with the development of shyness across adolescence. Thus, youth generally decline in shyness during adolescence, although there is substantial individual variability in shyness trajectories.

The role of temperament in the onset of suicidal ideation and behaviors across adolescence: Findings from a 10-year longitudinal study of Mexican-origin youth

Suicide among young people is an increasingly prevalent and devastating public health crisis around the world. To reduce the rate of suicide, it is important to identify factors that can help us better predict suicidal ideation and behaviors. Adolescent temperament (effortful control, negative emotionality, positive emotionality) may be a source of risk and resilience for the onset of suicidal ideation, plans, and attempts. The present study uses longitudinal data from a large, community sample of Mexican-origin youth (N = 674), assessed annually from age 12 to 21, to examine how temperament is associated with the onset of suicidal ideation and behaviors during adolescence and young adulthood. Results indicate that higher levels of effortful control (activation control, inhibitory control, attention) are associated with decreased probability of experiencing the onset of suicidal ideation, plans, and attempts, whereas higher levels of negative emotionality (particularly aggression, frustration, and depressed mood) are associated with increased probability of experiencing the onset of suicidal ideation and behaviors. Positive emotionality (surgency, affiliation) was not associated with the onset of suicidal ideation and behaviors. Supplemental analyses showed conceptually similar findings for the Big Five, with Conscientiousness associated with decreased risk, Neuroticism associated with increased risk, and the other three dimensions showing largely null results. The findings did not vary significantly for boys and girls or for youth born in the U.S. versus Mexico. Overall, these findings suggest that adolescent temperament serves as both a protective factor (via effortful control/Conscientiousness) and a risk factor (via negative emotionality/Neuroticism) for suicidal ideation and behaviors in Mexican-origin youth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The structure of adolescent temperament and associations with psychological functioning: A replication and extension of Snyder et al. (2015)

The present study attempts to replicate and extend Snyder et al. (2015, JPSP). The original study examined the latent factor structure of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R), a commonly used measure of adolescent temperament, and showed that the resulting latent factors (i.e., effortful control, negative emotionality, and positive emotionality) had theoretically meaningful concurrent associations with several measures of adolescent functioning (depression, anxiety, attention-deficit hyperactivity disorder [ADHD], relational aggression, and school performance and behavior). We performed these same analyses using data from a large sample of Mexican-origin youth (N = 674), and also examined prospective associations between the three EATQ-R factors and measures of adolescent functioning assessed two years later. We found some evidence supporting the bifactor models reported in the original study but poor replication of the correlations among latent factors. Additionally, model comparisons demonstrated that correlated factors models produced more interpretable factors than the bifactor models. In contrast, we replicated most of the concurrent correlations (and extended the findings to prospective associations) between the EATQ-R factors and measures of adolescent functioning, supporting the construct validity of the EATQ-R as a measure of adolescent temperament. Thus, these findings raise concerns about the generalizability of the factor structure identified by Snyder et al. (2015), but bolster claims about the generalizability of the concurrent and predictive validity of the EATQ-R. Overall, differences between the present findings and those of Snyder et al. (2015) highlight the importance of ongoing construct validation in youth temperament research, especially with participants from groups traditionally underrepresented in psychological research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Big five personality traits and common mental disorders within a hierarchical taxonomy of psychopathology: A longitudinal study of Mexican-origin youth

The present study (a) tested whether a structure of common mental disorders within the hierarchical taxonomy of psychopathology was invariant from late childhood to adolescence in a sample of Mexican-origin youth, (b) examined the developmental course of psychopathology at different levels of the hierarchy, and (c) tested the degree to which changes in psychopathology were associated with changes in the Big Five personality domains. Results were consistent with the longitudinal hierarchical invariance of common mental disorders from age 12 to 17 (n = 674). Further, initial levels of conscientiousness, agreeableness, and emotional stability were positively associated with lower initial levels of a higher order factor of psychopathology, and increases in extraversion and decreases in neuroticism were associated with decreases in a higher order factor of psychopathology, which captured the general tendency for externalizing, internalizing, and attention-hyperactivity-related dimensions of psychopathology to correlate. Results of the present study indicate that a hierarchical model of common mental disorders extends to Mexican-origin youth and that developmental change in Big Five personality are related to developmental change in psychopathology. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence

PURPOSE

An emerging body of work suggests a link between childhood maltreatment and attention-deficit hyperactivity disorder (ADHD). However, research examining the role of maltreatment in the early course of the disorder lacks robust evidence from longitudinal studies. Our aim was to examine concurrent and prospective associations between maltreatment experiences and ADHD diagnosis and sex differences, and to estimate the association between repetitive maltreatment exposure and ADHD through childhood and adolescence.

METHODS

Data were obtained from the Boricua Youth Study, a longitudinal study of 2480 children and adolescents of Puerto Rican background. Neglect, physical, emotional and sexual abuse, and foster placement were regressed on ADHD diagnosis measured at each of three waves using the Diagnostic Interview Schedule for Children-IV. Multilevel regressions estimated the effects of exposure on ADHD, adjusted by age, sex, income, household education, parental psychopathology, comorbidity and ADHD medication status.

RESULTS

Emotional abuse and foster placement had robust associations with ADHD diagnosis. For girls, physical abuse had a threefold increase in the odds of having ADHD diagnosis; for boys, associations were observed only for emotional abuse. Prospective models examining the risk of ADHD following maltreatment provided initial evidence for the effects of physical abuse on ADHD, and a linear trend for repetitive exposure suggested increased probability for disorder persistence.

CONCLUSIONS

Associations between early maltreatment and ADHD were robust. Different categories of maltreatment increase the likelihood of ADHD for girls and boys. Increased exposure to maltreatment may predict symptom persistence. Interventions addressing ADHD must consider the effects of both sex and family environment.

The role of effortful control in the development of ADHD, ODD, and CD symptoms

Many adolescents have difficulty regulating their impulses and become prone to externalizing problems (e.g., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and other adverse consequences. Using multimethod data from a longitudinal study of Mexican-origin youth (N = 674), assessed annually from age 10 to 16, we examined the relations between effortful control and ADHD, ODD, and CD symptoms over time. Bivariate latent growth curve models showed negative correlations between the trajectories of effortful control and ADHD, ODD, and CD, indicating that steeper decreases in effortful control were related to steeper increases in ADHD, ODD, and CD symptoms. Using a novel statistical technique, the factor of curves model (FOCUS), we found that ADHD, ODD, and CD share a common "externalizing" trajectory during adolescence. Although effortful control was strongly associated with this common trajectory, it had few unique associations with the individual disorder trajectories, above and beyond their shared trajectory. When we extended the FOCUS model to include the effortful control trajectory as an indicator, we found that ADHD and ODD had strong loadings, whereas effortful control and CD had comparatively weak loadings on the shared developmental trajectory. Follow-up analyses showed that a two-factor solution, with externalizing symptom trajectories on one factor and the effortful control facet trajectories on a separate factor, was a better fit to the data than a one-factor solution. Finally, parent ASPD symptoms were related to increases in CD, but had no significant influence on effortful control, ADHD, or ODD. We discuss the implications for personality and externalizing problem development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Initial evaluation of the validity and reliability of the culturally adapted Spanish CaSUN (S-CaSUN)

PURPOSE

There is a dearth of knowledge and limited research on the needs of Hispanic male cancer survivors (HMCSs). There is a clear need for the development of culturally and linguistically adapted needs assessment tools that are valid and reliable for use among the growing HMCS population. Thus, the purpose of this paper is to describe the field testing and psychometric evaluation of the translated and culturally adapted Spanish Cancer Survivor Unmet Needs Measure (S-CaSUN).

METHODS

Hispanic male cancer survivors (n = 84) completed the Spanish CaSUN (S-CaSUN), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General Population (FACT-GP). Construct validity of the S-CaSUN was assessed by correlation analysis among aforesaid measures. A test-retest procedure with 2-week delay was used to examine reproducibility with a participant subsample (n = 50). Cronbach's alpha was computed to assess internal consistency of the S-CaSUN.

RESULTS

Construct validity of the S-CaSUN was estimated by moderate correlation with the HADS anxiety (r = 0.55, P < 0.001) and depression scales (r = 0.60, P < 0.001) and the FACT-GP (r = - 0.62, P < 0.001). The test-retest correlation coefficient for the S-CaSUN was 0.78. Cronbach's alpha was 0.96. Field testing yielded a mean S-CaSUN score of 38.3 (SD = 26.2); all needs and positive change items were endorsed.

CONCLUSION

Findings from field testing and preliminary psychometric evaluation of the S-CaSUN provide initial evidence of validity and reliability of the measure and highlight the importance of going beyond translation when adapting measures to take culture, literacy, and language into consideration.

IMPLICATIONS FOR CANCER SURVIVORS

Reliable, culturally, and linguistically valid instruments facilitate identification of unique unmet needs of Hispanic cancer survivors that, in turn, can be addressed with evidence-based interventions. As cancer centers continue to develop survivorship programs, the S-CaSUN may be useful for a growing group of cancer survivors.

Developmental Psychopathology in a Racial/Ethnic Minority Group: Are Cultural Risks Relevant?

OBJECTIVE

The current study examined (a) the mediating role of parenting behaviors in the relationship between parental risks and youth antisocial behaviors (YASB), and (b) the role of youth cultural stress in a racial/ethnic minority group (i.e., Puerto Rican [PR] youth).

METHOD

This longitudinal study consisted of 3 annual interviews of PR youth (N = 1,150; aged 10-14 years at wave 1) and their caretakers from the South Bronx (SB) in New York City and from San Juan, Puerto Rico. Parents reported on parental risks, parenting behaviors, and YASB. Youth also self-reported on YASB and youth cultural stress. A lagged structural equation model examined the relationship between these variables across 3 yearly waves, with youth cultural stress as a moderator of the association between effective parenting behaviors and YASB.

RESULTS

Findings supported the positive influence of effective parenting on YASB, independently of past parental risks and past YASB: higher effective parenting significantly predicted lower YASB at the following wave. Parenting also accounted for (mediated) the association between the composite of parental risks and YASB. Youth cultural stress at wave 1 was cross-sectionally associated with higher YASB and moderated the prospective associations between effective parenting and YASB, such that for youth who perceived higher cultural stress, the positive effect of effective parenting on YASB was weakened compared to those with lower/average cultural stress.

CONCLUSION

Among PR families, both parental and cultural risk factors influence YASB. Such findings should be considered when treating racial/ethnic minority youth for whom cultural factors may be a relevant influence on determining behaviors.

Gender and the Interplay of Source of Support and Peer Social Rejection on Internalizing Among Mexican American Youth

Gendered interpersonal processes may explain the elevated rates of internalizing symptoms among adolescent girls relative to boys. Two such processes are peer social rejection and social support. The current study assessed for gender differences in the effect of 7th grade peer social rejection on 10th grade internalizing symptoms, as well as the moderating effects of social support from family and from friends in a sample of 749 (49 % female) Mexican American adolescents, an understudied population with a unique social culture. Peer social rejection significantly predicted increased internalizing symptoms for girls. Although buffering effects of social support were not found, there were significant moderating effects of both sources of support for boys, such that at low levels of social support, peer social rejection was associated with decreased internalizing symptoms, and at high levels of social support, peer social rejection was associated with increased internalizing symptoms. The results help unpack the nuances of the interpersonal processes that lead to differential adjustment for adolescent boys and girls at this critical developmental stage.

Childhood Adversity and Early Initiation of Alcohol Use in Two Representative Samples of Puerto Rican Youth

Early alcohol use is associated with multiple negative outcomes later in life, including substance use disorders. Identification of factors related to this very early risk indicator can help inform early prevention efforts. This study prospectively examined the relationship between childhood adversities and early initiation of alcohol use (by age 14) among Puerto Rican youth, the Latino subgroup at highest risk for alcohol use disorders in adulthood. The data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth in two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). We focus on youth who were ages 10 and older at Wave 1 [M age at Wave 1 (SE) = 11.64(0.05), N = 1259, 48.85 % females]. Twelve childhood adversities were measured at Wave 1 and include 10 adverse childhood experiences commonly studied and two additional ones (exposure to violence and discrimination) that were deemed relevant for this study's population. Early initiation of alcohol use was determined based on youth report at Waves 1 through 3 (each wave 1 year apart). Cox proportional hazards models showed that, when considered individually, adversities reflecting child maltreatment, parental maladjustment, and sociocultural stressors were related to early initiation of alcohol use. Significant gender interactions were identified for parental emotional problems and exposure to violence, with associations found among girls only. Adversities often co-occurred, and when they were considered jointly, physical and emotional abuse, parental antisocial personality, and exposure to violence had independent associations with early alcohol use, with a stronger influence of exposure to violence in girls compared to boys. The accumulation of adversities, regardless of the specific type of exposure, increased the risk for starting to drink at a young age in a linear way. The associations between childhood adversities and early alcohol use were generally consistent across sociocultural contexts, in spite of differences in the prevalence of exposure to adversity. Our findings highlight the importance of targeting multiple adversities and expanding the notion of adversity to capture the experiences of specific groups more adequately.

Clinical Validity of the ADI-R in a US-Based Latino Population

The Autism Diagnostic Interview-Revised (ADI-R) has been validated as a tool to aid in the diagnosis of Autism; however, given the growing diversity in the United States, the ADI-R must be validated for different languages and cultures. This study evaluates the validity of the ADI-R in a US-based Latino, Spanish-speaking population of 50 children and adolescents with ASD and developmental disability. Sensitivity and specificity of the ADI-R as a diagnostic tool were moderate, but lower than previously reported values. Validity of the social reciprocity and restrictive and repetitive behaviors domains was high, but low in the communication domain. Findings suggest that language discordance between caregiver and child may influence reporting of communication symptoms and contribute to lower sensitivity and specificity.

A Randomized Controlled Study of Cognitive-Behavioral Therapy for Posttraumatic Stress in Street Children in Mexico City

The study aimed to evaluate cognitive-behavioral therapy (CBT) for posttraumatic stress (PTS), depression, anxiety, and anger in street children by a randomized controlled trial of CBT versus a waitlist control. It was conducted in 8 residential facilities for street children in Mexico City, with assessments at baseline, posttreatment, and 3 months later. Children who reported at least moderate posttraumatic stress, and fulfilled the study requirement were enrolled in the study (N = 100, 12-18 years old, 36 boys). There were 51 children randomized to CBT and 49 to the waitlist condition. Randomization was stratified by gender. CBT consisted of 12 individual 1-hour sessions administered weekly by 2 trained, master's-level clinicians. Outcome measures included self-reports of PTS, depression, anxiety, and anger; global improvement was assessed by the independent evaluator. Compared to participants in the waitlist condition participants in CBT showed a significant reduction in all symptoms, with effects sizes of 1.73 to 1.75. At follow up there was attrition (n = 36), and no change from posttreatment scores. The study did find statistically significant improvement in symptoms in the CBT group compared to the waitlist condition; symptoms remained stable at 3 months. The study found that CBT for trauma in a sample of street children provided a reduction of a broad range of mental health symptoms.

Reliability and Validity of a Spanish Version of the Social Skills Rating System–Teacher Form

The aim of this study was to examine the psychometric properties of a Spanish version of the Social Skills Scale of the Social Skills Rating System–Teacher Form (SSRS-T) with a sample of children attending elementary schools in Puerto Rico ( N = 357). The SSRS-T was developed for use with English-speaking children. Although translated, adapted, and administered in Spanish, little was known about its psychometric properties. The authors evaluated the applicability of the Spanish SSRS-T by examining specifically its internal consistency, test-retest reliability, parent-teacher cross-informant correlations, and construct validity. Findings suggest that the Spanish SSRS-T is a valid and reliable instrument and support its potential utility in the early identification of social difficulties that may hinder the social, emotional, and academic adjustment of Latino children.

Spanish Adaptation of the Reasonsfor Living Inventory

The Reasons for Living Inventory (RFL) is an instrument to mea sure a range of beliefs potentially important as reasons for not com mitting suicide. There is no Spanish version of this instrument. The adaptation process includes translation, back-translation, review of both versions, and application of the resulting instrument to a bilingual sample from the tar get population. This process allows for assessment of the equivalence between the English and Spanish version of the RFL in three stages: linguistic equivalence, conceptual equivalence, and scale equivalence. The most important aspects of the adaptation, con ceptual and scale equivalence, are adequate in this Spanish version of the RFL. The adaptation of the RFL is ready to be used in Spanish-speaking populations.

Latino Immigrant Men's Perceptions of Depression and Attitudes Toward Help Seeking

Perceptions of depression, attitudes toward depression treatments, help-seeking preferences, and perceived barriers to care were examined in a sample of 56 Latino immigrant men recruited from a primary health care clinic. Each participant was presented a vignette depicting an individual with major depression. Men described the vignette as a debilitating condition caused by social stressors that would improve with time. Men preferred counseling over medications and reported misconceptions about antidepressants. Faith in God and seeking help from family members were seen as important help-seeking strategies. Structural and financial barriers were prevalent among this sample of men. Implications for improving depression care for Latino immigrant men are discussed.

Qualitative Data Analysis and Interpretation in Counseling Psychology: Strategies for Best Practices

This article presents an overview of various strategies and methods of engaging in qualitative data interpretations and analyses in counseling psychology. The authors explore the themes of self, culture, collaboration, circularity, trustworthiness, and evidence deconstruction from multiple qualitative methodologies. Commonalities and differences that span across approaches are explored. Implications for how researchers address qualitative data analysis and interpretation in counseling psychology training and research are discussed.

A Framework for Translating an Evidence-Based Intervention from English to Spanish

This article describes the development of a framework for the Spanish language adaptation of an evidence-based intervention. A systematic literature search of language adaptation of interventions highlighted most published research focuses on the translation of assessment tools rather than interventions. In response, we developed the Participatory and Iterative Process Framework for Language Adaptation (PIPFLA), a descriptive step-by-step example of how to conduct the language adaptation of an intervention that is grounded in principles of good practice and facilitates transparency of the process. A bilingual team composed of project staff, translators, and two small panels of local community experts-composed of Latino community-based clinicians and Latino immigrant parents-participated in the language adaptation of the intervention. The panels reviewed the translated materials and offered their independent emic perspectives; the intervention represented the etic perspective. Both perspectives informed and were integrated into the 11-step iterative process that comprises the PIPFLA framework.

Exploring Mexican American adolescent romantic relationship profiles and adjustment

Although Mexican Americans are the largest ethnic minority group in the nation, knowledge is limited regarding this population's adolescent romantic relationships. This study explored whether 12th grade Mexican Americans' (N = 218; 54% female) romantic relationship characteristics, cultural values, and gender created unique latent classes and if so, whether they were linked to adjustment. Latent class analyses suggested three profiles including, relatively speaking, higher, satisfactory, and lower quality romantic relationships. Regression analyses indicated these profiles had distinct associations with adjustment. Specifically, adolescents with higher and satisfactory quality romantic relationships reported greater future family expectations, higher self-esteem, and fewer externalizing symptoms than those with lower quality romantic relationships. Similarly, adolescents with higher quality romantic relationships reported greater academic self-efficacy and fewer sexual partners than those with lower quality romantic relationships. Overall, results suggested higher quality romantic relationships were most optimal for adjustment. Future research directions and implications are discussed.

Loss Due to Death and its Association with Mental Disorders in Juvenile Detainees

This study investigated the prevalence of loss due to death and its association with mental disorders in a random sample of 898 newly detained adolescents in Chicago, Illinois. Nearly 90% of youth experienced the loss of an important person; most had also experienced a "high-risk" loss (e.g., loss due to violence, sudden loss). Minority youth were at particular risk. Youth with any loss or multiple losses were more likely to have mood disorders and ADHD/behavioral disorders, respectively, than youth who had no such losses. Interventions focusing on modifiable protective factors following loss may increase positive outcomes in this vulnerable population.

The Role of Peers in the Relation between Hurricane Exposure and Ataques de Nervios among Puerto Rican Adolescents

Although a relation between disaster exposure and ataques de nervios (ataques) has been established in adult samples, little is known about this among youth, including factors that may moderate this relation. This study examined the role of the peer context in the relation between exposure to Hurricane Georges and experiencing a past year and lifetime ataques among a representative community sample of 905 youth (N = 476 boys and 429 girls; ages 11-18) residing in Puerto Rico. Data were gathered from 1999-2000 in Puerto Rico, 12-27 months following Hurricane Georges. Logistic regression analyses found that peer violence significantly predicted experiencing an ataque in the past year. Hurricane exposure and peer violence were both significant predictors of a lifetime experience of an ataque. An interaction was found between hurricane exposure and peer violence, indicating that hurricane exposure was significantly related to a lifetime experience of an ataque among adolescents who do not report associating with violent peers. For participants reporting high levels of peer violence, hurricane exposure did not add additional risk for a lifetime experience of an ataque. Understanding the influence of peers in the relation between hurricane exposure and experiencing an ataque may assist in planning developmentally and culturally sensitive response plans.

Developing an African youth psychosocial assessment: an application of item response theory

This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (θ) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended.

Contextual risk and promotive processes in Puerto Rican youths' internalizing trajectories in Puerto Rico and New York

Research on ethnic-minority youths' mental health has rarely examined developmental trajectories for the same ethnic group in contexts where they are a minority versus where they are the majority or mechanisms accounting for differences in trajectories across such contexts. This study examines Puerto Rican youth residing in two contexts, one in which they are in their home culture of Puerto Rico and one in which they are a minority group, in New York. We explore the relationship among social context, minority status, risk, resilience, and trajectories of internalizing symptoms after adjusting for factors related to migration. We found that youths' reports of internalizing symptoms declined over time. Youths in New York had higher levels of internalizing symptoms than did youths in Puerto Rico, but they had similar trajectories. Differences in internalizing symptoms across the two social contexts were accounted for by experiences of discrimination and exposure to violence. Parental monitoring was associated with fewer internalizing symptoms across the two sites, although this effect diminished over time. Contrary to what was expected, family religiosity was associated with higher levels of internalizing symptoms. This association was stronger in New York than in the Puerto Rico site.

German translation of the Alberta Context Tool and two measures of research use: methods, challenges and lessons learned

Background

Understanding the relationship between organizational context and research utilization is key to reducing the research-practice gap in health care. This is particularly true in the residential long term care (LTC) setting where relatively little work has examined the influence of context on research implementation. Reliable, valid measures and tools are a prerequisite for studying organizational context and research utilization. Few such tools exist in German. We thus translated three such tools (the Alberta Context Tool and two measures of research use) into German for use in German residential LTC. We point out challenges and strategies for their solution unique to German residential LTC, and demonstrate how resolving specific challenges in the translation of the health care aide instrument version streamlined the translation process of versions for registered nurses, allied health providers, practice specialists, and managers.

Methods

Our translation methods were based on best practices and included two independent forward translations, reconciliation of the forward translations, expert panel discussions, two independent back translations, reconciliation of the back translations, back translation review, and cognitive debriefing.

Results

We categorized the challenges in this translation process into seven categories: (1) differing professional education of Canadian and German care providers, (2) risk that German translations would become grammatically complex, (3) wordings at risk of being misunderstood, (4) phrases/idioms non-existent in German, (5) lack of corresponding German words, (6) limited comprehensibility of corresponding German words, and (7) target persons’ unfamiliarity with activities detailed in survey items. Examples of each challenge are described with strategies that we used to manage the challenge.

Conclusion

Translating an existing instrument is complex and time-consuming, but a rigorous approach is necessary to obtain instrument equivalence. Essential components were (1) involvement of and co-operation with the instrument developers and (2) expert panel discussions, including both target group and content experts. Equivalent translated instruments help researchers from different cultures to find a common language and undertake comparative research. As acceptable psychometric properties are a prerequisite for that, we are currently carrying out a study with that focus.

The use of the autism diagnostic interview-revised with a latino population of adolescents and adults with autism

Research shows that Latinos are less likely to be diagnosed with autism than their non-Latino counterparts. One factor that may contribute to these differences is that autism diagnostic instruments have not been adapted for the Latino population. The present study compared scores from the Autism Diagnostic Interview-Revised for two groups: 48 Latino adolescents and adults with autism and a matched sample of 96 non-Latino Whites. There were no significant differences between the two groups in total impairments in social reciprocity or communication. However, lower levels of restrictive-and-repetitive behaviors were found among Latino adolescents and adults with autism compared to Whites. Findings suggest that there may be cultural equivalency in some domains, but others may warrant further exploration.

Peer deviance, social support, and symptoms of internalizing disorders among youth exposed to Hurricane Georges

This study examined the influence of peers in meeting DSM-IV symptom criteria for an internalizing disorder in adolescents exposed to Hurricane Georges. Participants included a representative community sample of 905 youth (n = 476 boys) ages 11-17, residing in Puerto Rico. Data were gathered on hurricane exposure, symptoms of internalizing disorders, peer social support, peer violence, and peer substance use through in-person structured interviews with adolescents and caretakers from 1999 to 2000 in Puerto Rico, 12-27 months after Hurricane Georges. Hurricane exposure, peer violence, and peer substance use predicted whether adolescents met DSM-IV symptom criteria for a measured internalizing disorder. An interaction was found between hurricane exposure and peer violence, which indicated that hurricane exposure was significantly related to meeting DSM-IV symptom criteria for an internalizing disorder among adolescents who do not report associating with violent peers. However, for participants who reported high levels of peer violence, hurricane exposure did not convey additional risk for meeting DSM-IV symptom criteria for an internalizing disorder. With the increasing role peers play in adolescents' lives, understanding the influence of peers on the development of internalizing symptoms following hurricane exposure may assist in planning developmentally sensitive response plans.

Contextual amplification or attenuation of pubertal timing effects on depressive symptoms among Mexican American girls

PURPOSE

To examine the role of neighborhood contextual variation in the putative association between pubertal timing and depressive symptoms among Mexican-origin girls.

METHOD

Mexican-origin girls (N = 344; x̄(age) = 10.8 years) self-reported their total pubertal, adrenal, and gonadal events, along with levels of depressive symptoms in the 5th grade. Girls' residential addresses were geocoded into neighborhoods, and census data were obtained to describe neighborhoods along two dimensions: Hispanic cultural context and socioeconomic disadvantage. Two years later, when most of the girls were in the 7th grade, we reassessed the girls regarding depressive symptoms.

RESULTS

Neighborhood Hispanic composition and neighborhood disadvantage were highly positively correlated. Using hierarchical linear modeling, we examined the moderating influence of neighborhood Hispanic composition and neighborhood disadvantage on the prospective associations between pubertal timing (total, gonadal, and adrenal) and depressive symptoms. Neighborhood Hispanic composition moderated the prospective association between total pubertal and gonadal timing and depressive symptoms. Neighborhood disadvantage did not moderate these associations.

CONCLUSIONS

Our results suggest that early maturing 5th grade Mexican-origin girls living in non-Hispanic neighborhoods are at the greatest risk for increased depressive symptoms in the 7th grade, even though these neighborhoods tend to be socioeconomically more advantaged. The protective cultural context of largely Hispanic neighborhoods may outweigh the potential amplifying effects of neighborhood disadvantage.

A prospective study of Mexican American adolescents' academic success: considering family and individual factors

Mexican American youth are at greater risk of school failure than their peers. To identify factors that may contribute to academic success in this population, this study examined the prospective relationships from 5th grade to 7th grade of family (i.e., human capital [a parent with at least a high school education], residential stability, academically and occupationally positive family role models, and family structure) and individual characteristics (i.e., externalizing symptoms, bilingualism, gender, and immigrant status) to the academic performance of 749 Mexican American early adolescents (average age = 10.4 years and 48.7% were girls in 5th grade) from economically and culturally diverse families as these youth made the transition to junior high school. Results indicated that while controlling for prior academic performance, human capital and positive family role models assessed when adolescents were in 5th grade positively related to academic performance in 7th grade. Further, being a girl also was related to greater 7th grade academic success, whereas externalizing symptoms were negatively related to 7th grade academic performance. No other variables in the model were significantly and prospectively related to 7th grade academic performance. Implications for future research and interventions are discussed.

Genetic and Environmental Influences on Temperament in the First Year of Life: The Puerto Rico Infant Twin Study (PRINTS)

Three dimensions of temperament — difficult temperament, unadaptablility and unsociability — were assessed in the first year of life by maternal interview in twins born in Puerto Rico during 2001 and 2002. Eight hundred and sixty-five eligible mothers (80%) were traced and interviewed. Model- fitting results showed that additive genetic factors and the individual specific environment contributed to variation in all three dimensions. In addition, the pattern of variances and correlations suggested that sibling contrast effects influence ratings of difficult temperament. Moderate effects of the shared environment contributed to ratings of adaptability and sociability. There was a significant genetic correlation between difficult temperament and unadaptability. Genetic and environmental effects do not differ significantly between boys and girls. The study is the first population-based study of Puerto Rican twins and one of few to attempt the assessment of behavior in the first year. Preliminary results for difficult temperament and sociability were consistent with those in other populations and ages. In contrast, a significant effect of the shared environment on the temperamental trait of unadaptability has not been reported previously.

Cross-cultural adaptation and preliminary validation of a zygosity determination questionnaire for twins in Sri Lanka

We report the process of adaptation into Sinhala of a questionnaire given to mothers of twins to determine zygosity. Adaptation and validation was carried out in three stages. Firstly, we used a nominal group to translate the English version and to assess the extent of agreement (consensus measurement) on the appropriateness of the translation and resolve disagreement (consensus development). Secondly we used a qualitative interview with 25 mothers of twins. The three main stems of the translated questionnaire were used as a semi-structured interview, and the responses noted verbatim. These were categorised and analysed, and the translated full questionnaire was then presented as closed questions with fixed choice responses. The categorised responses generated during the qualitative interview were compared with the responses to the fixed choices in the full questionnaire. The third stage was the appraisal of the questionnaire by 17 bilingual parents of twins. The source and translated version of the questionnaire were given to them at least 3 days apart. The responses were rated and the total scores were computed to determine the zygosity. This step was carried out to measure the validity and reliability of the Sinhala version. A perfect correlation between the original and adapted version was obtained, with a kappa of 1. The results suggest that the Sinhala version of the questionnaire is conceptually equivalent to the original questionnaire. Comparison of the zygosity determination by using this adapted questionnaire with results from analysis of genetic markers on Sri Lankan twins is needed for final validation of the translated questionnaire. Twin Research (2000) 3, 205–212.

Language Measurement Equivalence of the Ethnic Identity Scale With Mexican American Early Adolescents

The current study considers methodological challenges in developmental research with linguistically diverse samples of young adolescents. By empirically examining the cross-language measurement equivalence of a measure assessing three components of ethnic identity development (i.e., exploration, resolution, and affirmation) among Mexican American adolescents, the study both assesses the cross-language measurement equivalence of a common measure of ethnic identity and provides an appropriate conceptual and analytical model for researchers needing to evaluate measurement scales translated into multiple languages. Participants are 678 Mexican-origin early adolescents and their mothers. Measures of exploration and resolution achieve the highest levels of equivalence across language versions. The measure of affirmation achieves high levels of equivalence. Results highlight potential ways to correct for any problems of nonequivalence across language versions of the affirmation measure. Suggestions are made for how researchers working with linguistically diverse samples can use the highlighted techniques to evaluate their own translated measures.

Factor Structure of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA)

The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the Escala de Autoeficacia para la Depresión en Adolescentes (EADA): a Spanish instrument designed to assess this construct as experienced by this population. Participants were 116 Puerto Rican adolescents aged 13 to 17 years who completed the EADA and two other self-report measures. An exploratory factor analysis yielded a two-factor solution (Personal Self-Efficacy for Depression and Interpersonal Self-Efficacy for Depression) accounting for 37.57% of the total variance. Results revealed that EADA factors have excellent internal consistency as well as concurrent and construct validity, supporting its adequacy to assess Latino adolescents' self-efficacy for depression. The conceptual meaning of the factors was consistent with the distinction between aspects of this construct hypothesized to be important among Latino youth.

Economic hardship, neighborhood context, and parenting: prospective effects on Mexican-American adolescent's mental health

This study examined family and neighborhood influences relevant to low-income status to determine how they combine to predict the parenting behaviors of Mexican-American mothers and fathers. The study also examined the role of parenting as a mediator of these contextual influences on adolescent internalizing and externalizing symptoms. Study hypotheses were examined in a diverse sample of Mexican-American families in which 750 mothers and 467 fathers reported on their own levels of parental warmth and harsh parenting. Family economic hardship, neighborhood familism values, and neighborhood risk indicators were all uniquely associated with maternal and paternal warmth, and maternal warmth mediated the effects of these contextual influences on adolescent externalizing symptoms in prospective analyses. Parents' subjective perceptions of neighborhood danger interacted with objective indicators of neighborhood disadvantage to influence maternal and paternal warmth. Neighborhood familism values had unique direct effects on adolescent externalizing symptoms in prospective analyses, after accounting for all other context and parenting effects.

Measuring HIV felt stigma: a culturally adapted scale targeting PLWHA in Puerto Rico

The objective of this study was to culturally adapt and validate a scale to measure HIV-related felt stigma in a group of People living with HIV/AIDS (PLWHA) in Puerto Rico. The researchers conducted a two-phase cross-sectional study with 216 participants (60, first phase; 156, second phase). The first phase consisted of the cultural adaptation of the scale; the second evaluated its psychometric properties. After conducting a factor analysis, a 17-item scale, the HIV Felt-Stigma Scale (HFSS), resulted. Participants completed the Puerto Rico Comprehensive Center for the Study of Health Disparities Socio-demographic Questionnaire, the HFSS, the Beck Depression Inventory-II, and the Sexual Abuse dimension of the History of Abuse Questionnaire; the case managers completed the Case Manager Stigma Guide with subjects. The HFSS measures four dimensions: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. The alpha and Pearson correlation coefficients (0.91 and 0.68, respectively) indicated satisfactory validity and reliability; the scale suggested adequate convergent validity. The HFSS is a culturally sensitive instrument that fills the existing gap in the measurement of felt stigma in Spanish-speaking PLWHA.

Neighborhood Disadvantage, Stressful Life Events, and Adjustment Among Mexican American Early Adolescents

This study examined a stress-process model in which stressful life events and association with delinquent peers mediated the relationship of neighborhood disadvantage to Mexican American early adolescents' mental health. We also proposed that child gender, child generation, and neighborhood informal social control would moderate the relationship of neighborhood disadvantage to children's experiences of stressful life events. With data from 738 Mexican American early adolescents, results generally provided support for the theoretical model although the relationships of neighborhood disadvantage to stressful life events and adjustment were weaker than expected. Additional research is needed to corroborate these results and determine why neighborhood disadvantage may have different relationships to adjustment for Mexican American early adolescents than for others.

A Study of the Predictive Validity of the Children’s Depression Inventory for Major Depression Disorder in Puerto Rican Adolescents

This study aims to evaluate the predictive validity of the Children’s Depression Inventory items for major depression disorder (MDD) in an outpatient clinic sample of Puerto Rican adolescents. The sample consisted of 130 adolescents, 13 to 18 years old. The five most frequent symptoms of the Children’s Depression Inventory that best predict the presence of MDD were “I worry about others’ aches and pains,” “I don’t have any friends,” “I have to push myself to do my schoolwork,” “I have trouble sleeping every night,” and “I do very badly in subjects I used to be good in.” Results demonstrated that the symptoms that best predict MDD in Puerto Rican adolescents are not necessarily the ones commonly described as characteristic of the disorder.

Family and neighborhood fit or misfit and the adaptation of Mexican Americans

In this study, a person-environment fit model was used to understand the independent and combined roles of family and neighborhood characteristics on the adjustment of adults and children in a sample of 750 Mexican American families. Latent class analysis was used to identify six qualitatively distinct family types and three quantitatively distinct neighborhood types using socioeconomic and cultural indicators at each level. The results showed that members of single-parent Mexican American families may be particularly at-risk, members of the lowest-income immigrant families reported fewer adaptation problems if they lived in low-income neighborhoods dominated by immigrants, members of economically successful immigrant families may be more at-risk in integrated middle class neighborhoods than in low-income neighborhoods dominated by immigrants, and members of two-parent immigrant families appear to be rather resilient in most settings despite their low socioeconomic status.

Measuring child exposure to violence and mental health reactions in epidemiological studies: challenges and current issues

This paper examines challenges and current issues involved in measuring exposure to different types of violence which are associated mental health problems in children and adolescents. Standardized measures suitable for epidemiological studies, selected based on their relevance in the current literature, are briefly described and commented. The assessment of child's exposure to violence may focus on a specific event (e.g., kidnapping), a specific context (e.g., war) or even of a certain type of exposure (e.g., intrafamilial physical violence). The assessment of child mental health after exposure to violence has traditionally focused on posttraumatic stress disorder (PTSD) - most frequently measured through non-diagnostic scales. However, other mental health reactions may be present and screening as well as diagnostic instruments which may be used to assess these reactions are also described. Two issues of emerging importance - the assessment of impairment and of traumatic grief in children - are also presented. Availability of culturally appropriate instruments is a crucial step towards proper identification of child mental health problems after exposure to violence.

Psychometric properties of the Spanish BASIS-24 mental health survey

To assess mental health status among Latinos, culturally and linguistically appropriate instruments are needed. The purpose of this study was to assess psychometric properties and sensitivity of the Spanish revised Behavior and Symptom Identification Scale (BASIS-24), a self-report mental health assessment instrument first developed and validated in English. The Spanish translation was field tested among Spanish-speaking recipients of inpatient (N = 283) or outpatient (N = 311) mental health services in Massachusetts, Puerto Rico, and California. BASIS-24 was completed within 72 h of admission and up to 48 h before discharge (for inpatients) or at intake and 30-60 days later for outpatients. Confirmatory factor analysis indicated adequate fit for the model obtained from the English instrument. Internal consistency reliability exceeded 0.70 for five of the six factors. Concurrent and discriminant validity were partially supported. Improvement following treatment was statistically significant, with small to moderate effect sizes.

Testing language effects in psychiatric epidemiology surveys with randomized experiments: results from the National Latino and Asian American Study

To evaluate the prevalence of mental disorders for persons of non-English-language origin, it is essential to use translated diagnostic interviews. The equivalence of translated surveys is rarely tested formally. In the National Latino and Asian American Study (NLAAS), the authors tested whether a carefully translated mental health survey administered in Spanish produced results equivalent to those obtained by the original English version, using a randomized survey experiment. The NLAAS is a nationally representative survey carried out in the United States in 2002-2003. Bilingual respondents from the Latino section of the NLAAS (n = 332) were randomly assigned to receive either a Spanish- or English-language version of the World Mental Health Survey Composite International Diagnostic Interview. In tests of differences in lifetime and 12-month prevalences of 11 diagnoses and four higher-order aggregate disorder categories, in only one case was there an apparent difference between randomized language groups: Lifetime reports of generalized anxiety disorder were more prevalent in the bilingual group assigned to English than in the group interviewed in Spanish. Detailed follow-up analyses did not implicate any specific question in the generalized anxiety disorder protocol. Translation and back-translation of surveys does not guarantee that response probabilities are exactly equivalent. Randomized survey experiments should be incorporated into cross-cultural psychiatric surveys when possible.

Suicidal ideation and behaviors among youths in juvenile detention

OBJECTIVE

To examine suicidal ideation, suicide attempts, lethality of suicide attempts, and the relationship between psychiatric disorder and recent attempts in newly detained juveniles.

METHOD

The sample included 1,829 juveniles, ages 10 to 18 years, sampled after intake to a detention center in Chicago. Interviewers administered the Diagnostic Interview Schedule for Children to assess for thoughts of death, suicidal ideation, suicide plans, lifetime suicide attempts, number of attempts, age at first attempt, attempts within the past 6 months, method of suicide attempts, and psychiatric disorder.

RESULTS

More than one third of juvenile detainees and nearly half of females had felt hopeless or thought about death in the 6 months before detention. Approximately 1 in 10 (10.3%, 95% confidence interval: 7.7%-12.8%) juvenile detainees had thought about committing suicide in the past 6 months, and 1 in 10 (11.0%, 95% confidence interval: 8.3%-13.7%) had ever attempted suicide. Recent suicide attempts were most prevalent in females and youths with major depression and generalized anxiety disorder.

CONCLUSIONS

Fewer than half of detainees with recent thoughts of suicide had told anyone about their ideation. Identifying youths at risk for suicide, especially those suffering from depressive and anxiety disorders, is a crucial step in preventing suicide.

Perceived barriers to mental health services among youths in detention

OBJECTIVE

To examine perceived barriers to mental health service use among male and female juvenile detainees.

METHOD

The sample included 1,829 juveniles newly detained in Chicago. The Diagnostic Interview Schedule for Children and Children's Global Assessment Scale were used to determine the need for services. Service use and barriers to services were assessed with the Service Utilization and Risk Factors interview.

RESULTS

Approximately 85% of youths with psychiatric disorders reported at least one perceived barrier to services. Most common was the belief that problems would go away without help. Generally, attitudes toward services were remarkably similar across sex and race. Among females, significantly more youths with past service use or referral to services reported this barrier than did youths who had never received or been referred to services. Among males, significantly more youths who had been referred, but never received, services were unsure about where to go for help than youths with past service use. Significantly more youths with no past service use or referrals were concerned about the cost of services than youths with past service use.

CONCLUSIONS

Despite the pervasive need for mental health services, the findings of this study suggest that detained youths do not perceive the mental health system as an important or accessible resource. Youths who believe their problems can be solved without assistance are unlikely to cooperate with referrals or to independently seek mental health services. Service providers must be sensitive to clients' perceived barriers to mental health services and work to reduce negative perceptions of services.

An Icelandic version of the Kiddie-SADS-PL: translation, cross-cultural adaptation and inter-rater reliability

The development of structured diagnostic instruments has been an important step for research in child and adolescent psychiatry, but the adequacy of a diagnostic instrument in a given culture does not guarantee its reliability or validity in another population. The objective of the study was to describe the process of cross-cultural adaptation into Icelandic of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (Kiddie-SADS-PL) and to test the inter-rater reliability of the adapted version. To attain cross-cultural equivalency, five important dimensions were addressed: semantic, technical, content, criterion and conceptual. The adapted Icelandic version was introduced into an inpatient clinical setting, and inter-rater reliability was estimated both at the symptom and diagnoses level, for the most frequent diagnostic categories in both international diagnostic classification systems (DSM-IV and ICD-10). The cross-cultural adaptation has provided an Icelandic version allowing similar understanding among different raters and has achieved acceptable cross-cultural equivalence. This initial study confirmed the quality of the translation and adaptation of Kiddie-SADS-PL and constitutes the first step of a larger validation study of the Icelandic version of the instrument.

Latino immigrants' intentions to seek depression care

This study examined the role that illness perceptions, attitudes toward depression treatments, and subjective norms played in Latino immigrants' intentions to seek depression care. Ninety-five Latino immigrant patients were presented a vignette depicting an individual with major depression and interviewed about their intentions to seek care if confronted with a similar situation. Patients' preferences were to rely on informal sources of care first, and then turn to formal sources to cope with depression. Findings showed Latinos immigrants' help-seeking intentions for depression were a function of their views of depression, attitudes toward their doctors' interpersonal skills, and social norms related to seeking professional care after controlling for demographics, health insurance status, acculturation, clinical characteristics, perceived barriers to care, and past service use.