The role of familism in the relation between parent-child discord and psychological distress among emerging adults of Mexican descent

Familism moderates the association between parent-child conflict, interpersonal needs, and suicidal ideation among adolescents

Within the framework of the interpersonal theory of suicide, parent-child conflict in adolescence may be associated with suicidal ideation through increases in thwarted interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness). Familism, a cultural value that emphasizes prioritizing familial interconnectedness and honor, may moderate the association between parent-child conflict and thwarted interpersonal needs. This study examined the relationship between parent-child conflict, familism, and suicidal ideation through the interpersonal theory of suicide. Participants were N = 250 psychiatrically hospitalized adolescents aged 12-17 years (Mage = 14.84, 60.8% female; 41.9% Hispanic, 21.5% African American/Black, 26.0% Caucasian). Participants completed survey and interview measures prior to discharge from psychiatric hospitalization. There was a significant conditional indirect effect of parent-child conflict on suicidal ideation through thwarted interpersonal needs [F (3, 246) = 54.41, p < .01], such that the strength of the indirect effects family conflict on suicidal ideation via thwarted interpersonal needs increased as familism increased. Findings indicate that the relationship between parent-child conflict and thwarted interpersonal needs may be exacerbated when levels of familism are also high. For youth who endorse high levels of familism, parent-child conflict may be particularly pernicious. Interventions targeting the family environment are needed to potentially improve adolescents' interpersonal functioning and protect against suicidal ideation.

Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors

BACKGROUND

Familism, the cultural value that emphasizes feelings of loyalty and dedication to one's family, has been related to both positive and negative outcomes in Hispanic cancer survivors. One potential source of observed inconsistencies may be limited attention to the family environment, as familism may be protective in a cohesive family whereas it can exacerbate distress in a conflictive family.

PURPOSE

The current study explored the associations of familism with general and disease-specific health-related quality of life (HRQoL) in Hispanic men who completed prostate cancer (PC) treatment, and whether family cohesion may help explain these relationships.

METHODS

Hispanic men treated for localized PC (e.g., radiation, surgery) were enrolled in a randomized controlled stress management trial and assessed prior to randomization. Familism (familial obligation) was assessed using Sabogal's Familism Scale and family cohesion was measured using the Family Environment Scale (ranging from high to low). The sexual, urinary incontinence, and urinary obstructive/irritative domains of the Expanded Prostate Cancer Index Composite - Short Form measured disease-specific HRQoL. The physical, emotional, and functional well-being subscales of the Functional Assessment of Cancer Therapy - General captured general HRQoL. Hierarchical linear regression and the SPSS PROCESS macro were used to conduct moderation analyses, while controlling for relevant covariates.

RESULTS

Participants were 202 older men on average 65.7 years of age (SD = 8.0) who had been diagnosed with PC an average of 22 months prior to enrollment. Familism was not directly associated with general and disease-specific HRQoL. Moderation analyses revealed that greater familism was related to poorer urinary functioning in the incontinence (p = .03) and irritative/obstructive domains (p = .01), and lower emotional well-being (p = .02), particularly when family cohesion was low.

CONCLUSIONS

These findings underscore the importance of considering contextual factors, such as family cohesion, in understanding the influence of familism on general and disease-specific HRQoL among Hispanic PC patients. The combined influence of familism and family cohesion predicts clinically meaningful differences in urinary functioning and emotional well-being during the posttreatment phase. Culturally sensitive psychosocial interventions to boost family cohesion and leverage the positive impact of familistic attitudes are needed to enhance HRQoL outcomes in this population.

Examining the relationship between suicide ideation frequency and intergenerational acculturative conflict between Mexican descent college students and their caregivers using the interpersonal theory of suicide

INTRODUCTION

Suicide is the third leading cause of death among US young adults, with significant racial/ethnic disparities related to the risk for suicide among Latine young adults. Despite the elevated risk for suicide, culturally relevant risk factors are not well-known. Intergenerational acculturative conflict (IAC) among Latine youth is a sociocultural factor associated with suicide ideation.

METHOD

Although widely cited, the interpersonal theory of suicide (IPTS) lacks consistent support among Latine groups. The following cross-sectional study examined relationships between IAC categories (cultural preference, autonomy, and dating/staying out late), IPTS risk factors (i.e., thwarted belongingness and perceived burdensomeness), and suicide ideation frequency among 376 Mexican descent college students sampled using participant pools and snowball sampling (73.7% female: Mage  = 19.88).

RESULTS

Mediation analyses supported the hypotheses that IPTS risk factors partially explained the links between IAC categories and suicide ideation frequency.

CONCLUSIONS

These findings advance our understanding of how sociocultural constructs, such as IAC, influence the IPTS and future advancements in culturally responsive treatments for suicide.

Parent-child conflict and adolescent health literacy in Mexico: Results from a nationwide dyad study in Mexico

Research suggests that health literacy (HL) is critical in preventing and managing health problems. However, over half of adults in Mexico report having inadequate health literacy. Research suggests the parent-child relationship can be a key predictor of developmental competencies; however, little research has examined how dyadic family interactions relate to HL. This study examined whether parent-child relationship conflict was associated with adolescent health literacy among families living in Mexico. Data from a parent-child dyads in Mexico were gathered using online surveys (N = 746, 373 parent-child dyads). Our findings suggested that child-reported family conflict-but not parent-reported family conflict - was associated with lower adolescent health literacy. Researchers and practitioners should consider how parent-child conflict may impact adolescent health outcomes, and prioritise child reports in data collection.

A Contextual Behavioral Framework for Enhancing Cultural Responsiveness in Behavioral Service Delivery for Latino Families

In recent years, the field of behavior analysis has shifted its attention to issues of diversity, social justice, and cultural responsiveness. With various cultural groups in the United States, behavior analytic practitioners increasingly find themselves serving clients of diverse cultural backgrounds. One of the populations that continue to face underrepresentation is Latinos. In the current article, a cultural understanding of the Latino culture is provided to support cultural responsiveness in behavioral service delivery. This article explores the Latino identity of individuals receiving behavioral services, systemic barriers faced by Latinos, the use of acceptance and commitment training for Latino families and clients, and Latino cultural values and their role in behavioral service delivery. Most important, a shift in perspective to account for the barriers perceived by practitioners within the context of Latino cultural values is offered through a contextual behavioral framework, the literature, and the authors' personal and professional experiences as Latino behavior analysts. Recommendations in the areas of assessment, treatment design, service delivery, and collaboration when working with Latinos are also discussed.

Discrimination and Depressive Symptoms Among Mexican American Women: Exploring Multilevel Sociocultural Moderators

Relative to empirical studies on risk factors, less research has focused on culturally based protective factors that reduce the impact of discrimination on mental health. The current prospective study evaluated two potential moderators of the effect of discrimination on depressive symptoms among Mexican American women: individually held familism values and neighborhood cultural cohesion. Mexican-origin women in the United States (N = 322; mean age = 27.8 years; 86% born in Mexico) reported on frequency of discrimination, depressive symptoms, familism, and neighborhood cultural cohesion. Independent models evaluated familism and neighborhood cultural cohesion as moderators of the effect of discrimination on subsequent depressive symptoms. More frequent discrimination predicted higher subsequent depressive symptoms. High familism buffered the harmful effect of discrimination on depressive symptoms, such that more frequent discrimination was associated with higher subsequent depressive symptoms only for women who reported average and low familism. Neighborhood cultural cohesion did not buffer the effect of discrimination on depressive symptoms.

Daily links between Latinx siblings' relationship qualities and mood

This study examined daily links between sibling warmth and negativity and positive and negative mood in middle childhood and the moderating role of enculturation. Participants were 326 Latinx children from 163 families in the United States (Mage  = 10.63 and 8.58 years for older and younger siblings, 48.5% female, 89.3% Mexican-origin). Children reported their days' experiences during seven nightly phone interviews conducted in 2018-2019. Multilevel analyses revealed within-person, positive associations between daily sibling warmth and positive mood( OR = 1.81 , 95 % CI = [ 1.25 , 2.62 ] ) , and sibling negativity and negative mood ( OR = 3.21 , 95 % CI = [ 2.12 , 4.86 ] ) . Moreover, for more enculturated children, odds of positive mood were lower on days when they experienced more sibling negativity than usual. Findings document the significance of Latinx children's daily sibling experiences.

Discrimination as a Moderator of the Effects of Acculturation and Cultural Values on Mental Health Among Pregnant and Postpartum Latina Women

It is important to consider how identity, culture, and social adversity influence maternal mental health among Latina women both because this community faces unique cultural stressors and also because factors that undermine women's mental health during pregnancy and postpartum could have injurious consequences that cascade across generations. This study uses data from a questionnaire administered to Latina pregnant and postpartum women in Southern California, examining cultural orientation, discrimination, and mental health. Results demonstrate mental health benefits for both American and Latino cultural orientations, but the latter's benefit of lower anxiety was only apparent with high discrimination. American and Latino cultural values systems had opposite relationships with depression, with the latter protective and also positively associated with happiness. More traditional gender roles values were associated with greater perceived stress and lower happiness. Different aspects of familism had opposite effects as obligation was associated with less anxiety and referent (defining oneself communally with kin) with more. Results suggest that social adversity and cultural identity and values influence maternal psychology. This study makes a unique contribution by integrating anthropological and biopsychosocial methods and theories towards addressing an issue of public-health importance.

Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada

OBJECTIVE

This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY).

METHOD

SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed.

RESULTS

Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = - 5.79, p = .001) as well as increased reports of hope (agency: b = 0.84, p = .001; pathway: b = 0.79, p = .001), and coping by emotional support (b = 0.59, p < .001), instrumental support (b = 0.67, p < .001), positive framing (b = 0.59, p < .001), humour (b = 0.36, p = .014), planning (b = 0.49, p < .001) as well as reflective coping (b = 0.27, p = .009). Intervention participants were also less likely to perceive stress as a threat (b = - 0.43, p = .001), and more likely to perceive stress as challenge (b = 0.67, p < .001) and have the resources to deal with that stress (b = 0.38, p = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study.

CONCLUSIONS

Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.

Evolution of the Conceptualization of Filial Piety in the Global Context: From Skin to Skeleton

Social science researchers often define filial piety as a set of norms, values, and practices regarding how children should behave toward their parents. In this article, we trace the conceptual development of filial piety research in Chinese and other societies to highlight the assumptions underlying this traditional approach to filial piety research. We identify the limitations of these assumptions, including the problem of an evolving definition and lack of cross-cultural applicability. We then advocate an alternative framework that overcomes these limitations by focusing on the deep structure of filial piety: the dual filial piety model (DFPM). The DFPM applies the concept of contextualized personality to reconceptualize filial piety in terms of authoritarian and reciprocal psychological motivations particular to the parent-child context. Because the focus is on a universal psychological mechanism rather than cultural norms, values, and behavior, the DFPM may be applied for investigation of filial piety at individual, social, and cultural levels within and across various societies. We discuss application of the DFPM in relation to existing filial piety and intergenerational relations research from several societies and conclude with a comparison to other recent proposals for measuring Chinese filial piety.

Caregiver-Child Relationship Quality as a Gateway for Suicide Risk Resilience: Don't Discount the Men in Mexican Descent Youths' Lives

The purpose of the present study is to determine if connection with female (FC) and male caregivers (MC) could buffer the negative effects of intergenerational acculturative conflict (IAC) on suicide risk among Mexican descent adolescents and emerging adults. The sample included 722 Mexican descent adolescents and emerging adults (age range: 14-25 years, M = 19.69; SD = 1.75) from a U.S. high school and public university located near the United States-Mexico border. The majority of the sample were women (65.9%) and born in the United States (92.8%). Data were collected via self-report measures. The significant findings of linear regression analyses were: 1) Higher MC-IAC was related to higher levels of past year suicide risk, while higher levels of FC and MC connection were related to lower levels; and 2) Both MC and FC connection protected youth against the negative impact of IAC on suicide risk. Results are discussed in terms of the importance of both the MC and FC relationship quality in the context of IAC on suicide risk among Latinx youth. Suggestions will be made to include both MC and FC caregivers in research, prevention, and intervention efforts.

Measurement Properties of Sabogal's Familism Scale: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study

Familism is a central Hispanic/Latino cultural value that emphasizes close, supportive family relationships and prioritizing family over the self. One of its best-known measures is Sabogal's Familism Scale (Sabogal, Marin, Otero-Sabogal, VanOss Marin, & Perez-Stable, 1987). Although widely used, this scale's measurement properties are not well understood. This study addressed that gap by examining the factor structure, factorial invariance, convergent and discriminant validity, and internal consistency of Sabogal's Familism Scale using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. A diverse population-based sample of Hispanics/Latinos (N = 5,313) completed measures that were administered via interview in English or Spanish. Confirmatory factor analyses (n = 5,310) revealed that a three-factor model (familial obligations, perceived support from the family, family as referents; Sabogal's original three factors) fit the data well and did not vary across English and Spanish language groups (i.e., factorial invariance). Convergent and discriminant validities were also established; familism correlated positively with other Hispanic/Latino cultural values (simpatía, fatalism) and correlated negatively with U.S. acculturation. Internal consistency was acceptable. Sabogal's Familism Scale is recommended for continued use in the study of familism in U.S. Hispanics/Latinos.

Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women

BACKGROUND

Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age.

PURPOSE

The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women.

METHODS

Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year.

RESULTS

Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain.

CONCLUSIONS

Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.

Finding Home: A Qualitative Approach to Understanding Adolescent Mothers' Housing Instability

Many low-income Latina adolescent mothers face instability in their housing circumstances, which has implications for their long-term prospects and that of their children. This study used longitudinal, ethnographic data from Welfare, Children, and Families: A Three-City Study to explore experiences of low-income, Latina adolescent mothers (N = 15) with unstable housing who primarily rely on their families or the families of their significant others for housing support. Results of analysis employing grounded theory and narrative approaches suggested two types of instability: "Horizontal moves" between family homes and "vertical moves" between family homes and independent living. Although family support often was fundamental in allowing for participants' pursuit of independent housing (i.e., vertical moves), it also was associated with greater residential mobility (i.e., horizontal moves), most often in the context of intrafamilial conflict and family instability. These results are discussed with respect to inconsistencies in policies to address this vulnerable population.

Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support

Prenatal stress can have a lasting effect on women's mental health after childbirth. The negative effects may be particularly salient in women from low income and ethnic minority backgrounds, who are at increased risk for postpartum depression. However, social support may have the potential to attenuate the negative impact of stress. The present study evaluated 269 Mexican American women (ages 18-42; 83 % Spanish-speaking; median income $10,000-$15,000) for prenatal stress (daily hassles, family stress, partner stress, and culture-specific stress) in relation to depressive symptoms 6 weeks postpartum. Prenatal social support was examined as a buffer against the impact of prenatal stress. Partner stress, family stress, and daily hassles uniquely predicted depressive symptoms. Moderate and high levels of social support attenuated risk for depression due to family stressors. Prenatal interpersonal and daily stressors negatively impact the mental health of women after birth, but social support can mitigate some of these effects. Among Mexican American pregnant women, effective interpersonal support and stress management may be associated with reduced risk for postpartum depression.

Interparental conflict and adolescents' self-representations: The role of emotional insecurity

Adolescents' signs of emotional insecurity in the context of interparental conflict (IC) - emotional reactivity, internal representations (i.e., constructive/destructive; spillover) and behavioral responses (i.e., withdrawal; inhibition; involvement) - were examined as mediators in the relation between IC and adolescents' self-representations. Self-reported measures were filled out by 221 Portuguese adolescents (59.3% girls; Mage = 12.91), attending public elementary and secondary schools. IC predicted less favorable self-representations. Adolescents' emotional reactivity and withdrawal mediated the relation between IC and emotional and physical appearance self-representations, while conflict spillover representations and constructive family representations mediated associations between IC and instrumental self-representations. This study emphasizes the importance of interparental conflict and adolescent emotional insecurity in the construction of their self-representations, having important theoretical and practical implications. It highlights the value of analyzing the specific role of several emotional insecurity dimensions, and informs practitioners' work aimed at promoting constructive conflict and adaptive emotional regulation skills.

Acculturation and perceived discrimination: predictors of substance use trajectories from adolescence to emerging adulthood among Hispanics

PURPOSE

Previous studies have documented associations between cultural factors and substance use among Hispanic adolescents. Negative cultural experiences such as discrimination have been associated with an increased risk of substance use among Hispanic adolescents, whereas positive cultural resources, such as maintenance of Hispanic cultural orientations, have shown protective effects. However, few studies have examined the continuing influence of cultural factors on substance use from adolescence to emerging adulthood.

METHODS

We surveyed a cohort of Hispanic adolescents in Southern California in 9th, 10th, and 11th grades, and 3-4 years after high school. Growth curve analyses were conducted to examine the effects of U.S. acculturation, Hispanic acculturation, ethnic identity, and perceived discrimination on change in tobacco, alcohol, and marijuana use over time.

RESULTS

Higher perceived discrimination at baseline was significantly associated with a higher intercept (initial level) of tobacco, alcohol, and marijuana use. Higher initial level of Hispanic acculturation was significantly associated with a lower slope of tobacco, alcohol, and marijuana use.

CONCLUSIONS

Cultural phenomena such as acculturation and perceived discrimination can continue to affect substance use through the transition to emerging adulthood. Health education interventions are needed to help Hispanics navigate this developmental transition without engaging in substance use.

A personalized and control systems engineering conceptual approach to target childhood anxiety in the contexts of cultural diversity

In the child and adolescent anxiety area, some progress has been made to develop evidence-based prevention protocols, but less is known about how to best target these problems in children and families of color. In general, data show differential program effects with some minority children benefiting significantly less. Our preliminary data, however, show promise and suggest cultural parameters to consider in the tailoring process beyond language and cultural symbols. It appears that a more focused approach to culture might help activate intervention components and its intended effects by focusing, for example, on the various facets of familismo when working with some Mexican parents. However, testing the effects and nuances of cultural adaption vis-à-vis a focused personalized approach is methodologically challenging. For this reason, we identify control systems engineering design methods and provide example scenarios relevant to our data and recent intervention work.

Familism and psychological health: the intervening role of closeness and social support

Familism, a cultural value that emphasizes warm, close, supportive family relationships and that family be prioritized over self, has been associated with psychological health. The goal of this work was to fill a gap in the literature on how familism contributes to psychological health. Drawing from conceptual links between familism and close relationship processes, we hypothesized that familism contributes to better psychological health by facilitating closeness and social support. A university sample of U.S. women and men of Latino (n = 173), European (n = 257), and Asian (n = 642) cultural backgrounds completed measures of familism, closeness to family members, general perceived social support, and psychological health as indexed by perceived stress, general mental health, and depressive symptoms. Structural equation multiple-group modeling analyses found direct effects of familism on closeness to family members and perceived social support and an indirect effect of familism on better psychological health via greater closeness to family members and greater perceived social support. These effects did not differ by cultural background. Consistent with previous research, however, Latinos reported the highest levels of familism of the three cultural groups, and women reported higher familism and support as well as poorer psychological health than men. Discussion is focused on the implications of these findings for understanding the association of familism with psychological health and the relevance of the familism construct for diverse U.S. groups.

Differences in problem behaviour among ethnic minority and majority preschoolers in the Netherlands and the role of family functioning and parenting factors as mediators: the Generation R Study

Background

Studies have shown that, compared to native counterparts, preschoolers from ethnic minorities are at an increased risk of problem behaviour. Socio-economic factors only partly explain this increased risk. This study aimed to further unravel the differences in problem behaviour among ethnic minority and native preschoolers by examining the mediating role of family functioning and parenting factors.

Methods

We included 4,282 preschoolers participating in the Generation R Study, an ethnically-diverse cohort study with inclusion in early pregnancy. At child age 3 years, parents completed the Child Behavior Checklist (CBCL/1,5-5); information on demographics, socio-economic status and measures of family functioning (maternal psychopathology; general family functioning) and parenting (parenting stress; harsh parenting) were retrieved from questionnaires. CBCL Total Problems scores in each ethnic subgroup were compared with scores in the Dutch reference population. Mediation was evaluated using multivariate regression models.

Results

After adjustment for confounders, preschoolers from ethnic minorities were more likely to present problem behaviour than the Dutch subgroup (e.g. CBCL Total Problems Turkish subgroup (OR 7.0 (95% CI 4.9; 10.1)). When considering generational status, children of first generation immigrants were worse off than the second generation (P<0.01). Adjustment for socio-economic factors mediated the association between the ethnic minority status and child problem behaviour (e.g. attenuation in OR by 54.4% (P<0.05) from OR 5.1 (95% CI 2.8; 9.4) to OR 2.9 (95% CI 1.5; 5.6) in Cape Verdean subgroup). However, associations remained significant in most ethnic subgroups. A final adjustment for family functioning and parenting factors further attenuated the association (e.g. attenuation in OR by 55.5% (P<0.05) from OR 2.2 (95% CI 1.3; 4.4) to OR 1.5 (95% CI 1.0; 2.4) in European other subgroup).

Conclusions

This study showed that preschoolers from ethnic minorities and particularly children of first generation immigrants are at an increased risk of problem behaviour compared to children born to a Dutch mother. Although socio-economic factors were found to partly explain the association between the ethnic minority status and child problem behaviour, a similar part was explained by family functioning and parenting factors. Considering these findings, it is important for health care workers to also be attentive to symptoms of parental psychopathology (e.g. depression), poor family functioning, high levels of parenting stress or harsh parenting in first and second generation immigrants with young children.