Acculturative Stress, Mental Health, and Well-Being among Deaf Adults

Acculturative stress is associated with negative mental health among culturally diverse individuals. Deaf and Hard-of-Hearing (DHH) individuals experience acculturative stress as they navigate within and between the Hearing and Deaf communities, yet, research has not examined the relationship between deaf acculturative stress and psychological functioning. This study examined the relationships between deaf acculturative stress, well-being, and symptoms of depression and anxiety. One hundred and ten DHH adults (71.6% female, 82.7% White, median age = 30-39) completed an online survey including the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS), demographic questions, and measures of psychological functioning. After controlling for relevant sociodemographic factors, the MIDAS Stress from the Deaf and Hearing Community scales emerged as significant predictors of well-being and symptoms of anxiety and depression. Findings are discussed within the context of DHH sociocultural experiences, and suggestions for future research are offered to inform clinical work with DHH individuals.

Psychological Assessment Reports for Linguistically Minoritized Clients: Considerations for Ethical and Professional Practice

According to the national census, approximately a fifth of the adult population in the United States uses a language other than English in their home. Less precise information is available regarding the language preferences of children and adolescents, D/deaf individuals, and other individuals in the United States who are not represented in national surveys. The field of psychology has increasingly acknowledged and addressed the lived experiences of culturally and linguistically minoritized individuals in the United States through relevant research and clinical practice guidelines. As a result, more accessible and equitable practices for psychological assessments have been developed when working with linguistically minoritized clients. Unfortunately, there is a paucity of information in the extant literature regarding drafting psychological assessment reports for linguistically minoritized clients. This article explores the ethical and professional responsibilities of psychologists when engaged in this work, and provides proposed practices for drafting and delivering accessible assessment reports for linguistically minoritized clients. Recommendations are provided regarding how psychologists can share the results of an assessment with a referral source using written English and also support a client in accessing the information in their primary language.

Development of the Multidimensional Inventory of Deaf Acculturative Stress

Deaf adults may experience acculturative stress as they navigate within and between the Hearing and Deaf communities. However, no measure has been developed to assess levels of deaf acculturative stress. This study aimed to develop the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS). The MIDAS was developed through a sequential and iterative scale development procedure and then tested on a sample of 104 deaf adults across the United States (age range = 18-79; 74% female). Principal component analyses were run for item refinement and selection. The final analyses yielded four factors for Stress from the Hearing Community, three factors for Stress from the Deaf Community, and two factors for Intersectionality. Construct validity was demonstrated through correlations in the expected directions with measures of Hearing and Deaf acculturation identity and ethnic/racial identity. The utility of the MIDAS is discussed with regard to future research.

Characteristics of Psychologists Assessing Deaf and Hard of Hearing Clients

Psychological assessment plays a large part in the practice of psychology. Over the years, steps have been taken towards ensuring ethical and culturally sensitive psychological assessment for underserved populations, but little is known about the current state of the field of assessment of deaf and hard-of-hearing (DHH) individuals. An exploratory survey of school and clinical psychologists who work with DHH clients (n = 30) was conducted to obtain a snapshot of the state of the field. The current article focuses on sociodemographic characteristics, clinical training, clinical experiences, and language abilities of clinical psychologists who work with DHH clients. Participants averaged 15 years of assessment experience and almost all participants had some type of specialized training in assessing DHH clients. More than half of participants reported their ability to use multiple languages and communication approaches as either excellent or good. Current findings were compared with a similar survey from nearly 50 years ago (Levine, E. S. (1974). Psychological tests and practices with the deaf: A survey of the state of the art. Volta Review, 76, 298-319), and significant differences were found in participants' self-reported experience with DHH clients, training, and methods of communication.

Navigating Deaf and Hearing Cultures: An Exploration of Deaf Acculturative Stress

While there are many benefits of bilingualism and biculturalism, it is increasingly recognized that individuals may also experience acculturative stress as they navigate between different cultural environments. Acculturative stress results from struggles to acculturate, including pressures from the dominant culture and one's heritage culture to maintain specific languages, values, and customs. This study sought to explore experiences of acculturative stress among Deaf and Hard of Hearing (DHH) adults. Thirteen ethnically and racially diverse DHH adults, aged 21-52, participated in semi-structured focus groups. Krueger's (1994) framework analysis was used to analyze the data. Participants reported pressures from the Hearing community as Hearing, Speaking, and English Pressures; Hearing Cultural Expectations; and Family Marginalization. Pressures from the Deaf community included ASL Pressures; Deaf Cultural Expectations; and Small Community Dynamics. Participants also discussed unique stressors related to their intersecting cultural identities (Intersectionality). The psychosocial impacts of acculturative stress included anger, anxiety, depression, exhaustion, resentment, and trauma. Coping resources were also discussed. Results highlight the saliency of acculturative stress among DHH adults and the need for continued investigations of the construct, particularly as it relates to mental health.

Psychometric properties of the SAFE-D: A measure of acculturative stress among deaf undergraduate students

PURPOSE/OBJECTIVE

Members of minority groups may face stress as they navigate between their native culture and the dominant culture. No measure exists for evaluating acculturative stress among deaf individuals in the United States. The current study examined the psychometric properties of a modified version of the 24-item Social Attitudinal Familial and Environmental Acculturative Stress Scale (SAFE; Mena, Padilla, & Maldonado, 1987) for use with deaf undergraduate students (SAFE-D). Research Method/Design: 145 (88 females and 57 males), deaf, undergraduate students (Median age = 20.0; SD age = 4.9) from a bilingual, multicultural university were included in the study. Seventy-four percent were White, 10.4% Hispanic/Latino, 9.7% Black/African American, 0.7% Asian, and 9% multiracial. The SAFE-D included 23 items. Ten items were modified, 2 items were deleted, and 1 item was added.

RESULTS

The SAFE-D demonstrated high internal reliability (α = .931). Four factors were identified: Perceived Societal Barriers, Social Difficulties, Family Marginalization, and Discrimination. Evidence for construct validity was demonstrated through the association of SAFE-D scores with Deaf and Hearing acculturation.

CONCLUSIONS/IMPLICATIONS

Levels of acculturative stress in the current sample were close to those reported among late immigrant and English as a Second Language undergraduate students. The 4 factors did not match those of the original SAFE scale but reflected a bidirectional model of acculturative stress unique to deaf individuals. These findings suggest that acculturative stress is a serious concern among deaf undergraduate students and that the SAFE-D can be used to assess deaf acculturative stress in this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sexual Assault Experienced by Deaf Female Undergraduates: Prevalence and Characteristics

Approximately 25% of hearing women in the United States experience rape in their life-time, whereas deaf women have been found to experience increased rates of assault consistent with other marginalized populations. This study explored sexual assault prevalence and characteristics of assault in deaf female undergraduate students. Results revealed that more than two-thirds of the participants (69%) endorsed experiencing at least one assault and more than half (56%) experienced multiple types of assault. Most assaults were committed by a man known to the survivor. Characteristics (e.g., hearing status, primary language, and ethnicity) of the survivors and the assailants are explored. The implications of this data are discussed as well as the development of culturally and linguistically sensitive outreach and educational programs.

Social functioning and facial emotional expression in neurological and psychiatric disorders

This study examined the relationship between facial expression and social functioning in schizophrenic, depressed, right-brain-damaged, Parkinson's disease, and normal adult participants. Raters evaluated general intensity and amount of positive and negative facial emotion while participants were producing monologues regarding pleasant and unpleasant experiences. Social functioning items were derived from three standardized inventories. Overall, patient groups displayed more negative and less positive emotion than normals, and the schizophrenic and right-brain-damaged groups showed less intense expressions than normals. Correlational analyses suggested that the more intense the facial expressions, the better the social functioning, and that the more negative emotion displayed, the poorer the social functioning.

The effects of age and gender on the perception of lexical emotion

The primary purpose of this study was to examine the perception of lexical/verbal emotion across the adult life span. Secondary goals were to examine the contribution of gender and valence (i.e., pleasantness/unpleasantness) to the processing of lexical emotional stimuli. Participants were 28 young (ages 20-39), 28 middle-aged (ages 40-59), and 28 older (ages 60-85) right-handed adults; there were 14 men and 14 women in each age group. Age groups were comparable on demographic and cognitive variables. Participants made accuracy judgments and intensity ratings of emotional (both positive and negative) and nonemotional stimuli from lexical perception tasks from the New York Emotion Battery (Borod, Welkowitz, & Obler, 1992). Accuracy and intensity measures were not significantly correlated. When age was examined, older participants perceived emotional and nonemotional lexical stimuli with significantly less accuracy than did younger and middle-aged participants. On the other hand, older participants evaluated the nonemotional lexical stimuli as significantly more intense than younger participants. When gender was examined, lexical stimuli were processed more accurately by female than male participants. Further, emotional stimuli were rated more intense by female participants. Clinical implications of these findings are discussed.

Verbal pragmatics following unilateral stroke: emotional content and valence

Verbal pragmatic aspects of discourse production were examined in 16 right brain-damaged (RBD), 16 left brain-damaged (LBD), and 16 normal control right-handed adults. The facilitation effect of emotional content, valence hypothesis, and relationship between pragmatics and emotion were evaluated. Participants produced monologues while recollecting emotional and nonemotional experiences. Transcribed monologues were rated for appropriateness on 6 pragmatic features: conciseness, lexical selection, quantity, relevancy, specificity, and topic maintenance. Overall, brain-damaged groups were rated as significantly less appropriate than normals. Consistent with the facilitation effect, emotional content enhanced pragmatic performance of LBD aphasic participants yet suppressed performance of RBD participants. Contrary to the valence hypothesis, RBD participants were more impaired for positive emotions and LBD participants for negative emotions. Pragmatic appropriateness was not strongly correlated with a measure of emotional intensity.

Verbal pragmatics following unilateral stroke: emotional content and valence

Verbal pragmatic aspects of discourse production were examined in 16 right brain-damaged (RBD), 16 left brain-damaged (LBD), and 16 normal control right-handed adults. The facilitation effect of emotional content, valence hypothesis, and relationship between pragmatics and emotion were evaluated. Participants produced monologues while recollecting emotional and nonemotional experiences. Transcribed monologues were rated for appropriateness on 6 pragmatic features: conciseness, lexical selection, quantity, relevancy, specificity, and topic maintenance. Overall, brain-damaged groups were rated as significantly less appropriate than normals. Consistent with the facilitation effect, emotional content enhanced pragmatic performance of LBD aphasic participants yet suppressed performance of RBD participants. Contrary to the valence hypothesis, RBD participants were more impaired for positive emotions and LBD participants for negative emotions. Pragmatic appropriateness was not strongly correlated with a measure of emotional intensity.

A beneficial effect on mood in partial epilepsy patients treated with gabapentin

PURPOSE

Antiepileptic drugs (AEDs) are frequently used for their beneficial psychoactive effects on affective disorders. We sought to demonstrate a psychoactive effect of gabapentin (GBP) when used as add-on AED therapy.

METHODS

Forty adult patients with partial epilepsy were studied in a prospective, non-randomized fashion with interviewer-rated and self-rated scales of mood and anxiety: the Cornell Dysthymia Rating Scale (CDRS), Beck Depression Inventory (BDI), and Hamilton Depression (Ham-D) and Anxiety (Ham-A) Scales. After completion of baseline mood and anxiety scales (time 1), 20 of the 40 patients were prescribed add-on GBP (treated group). The remaining 20 patients served as a control group. Both groups were similar in age and sex distribution. Follow-up mood and anxiety scales were performed in all patients approximately 3 months later (time 2). The average GBP dose at time 2 was 1,615 mg/day. All patients were taking stable doses of one to four AEDs at baseline and throughout the study. Seizure frequency was monitored throughout. Statistical significance was assessed by analysis of variance (ANOVA) by using a two-factor repeated-measures model.

RESULTS

The GBP-treated group had a significant decrease in CDRS score over time compared with the control group (p = 0.04). No significant differences between the control and the treated groups were found for any of the remaining mood scales (BDI, p = 0.58; Ham-D, p = 0.59; Ham-A, p = 0.93). There was no significant difference or change in seizure frequency between groups.

CONCLUSIONS

GBP treatment is associated with mood improvement as measured by the CDRS. This improvement was not accounted for by seizure improvement.

Psychometric aspects of verbal pragmatic ratings

This study examined the psychometric aspects of a verbal pragmatic rating scale. The scale contained six pragmatic features (i.e., Conciseness, Lexical Selection, Quantity, Relevancy, Specificity, and Topic Maintenance) based on Grice's cooperative principles. Fifteen right brain-damaged (RBD), 15 left brain-damaged (LBD), and 16 healthy normal control (NC) right-handed adult participants produced narratives while recollecting emotional and nonemotional experiences. Naive raters evaluated each pragmatic feature for appropriateness on a 5-point Likert scale. When reliability was examined, the overall internal consistency of the pragmatic scale was extremely high (alpha =.96). Factor analysis was conducted to examine the theoretical relations among the six pragmatic features. Three meaningful factors involving discourse content, conceptual unity, and parsimony were identified. Findings are discussed in light of Grice's model and the construct validity of the scale.

A longitudinal study of neurobiological mechanisms in boys with attention-deficit hyperactivity disorder: preliminary findings

BACKGROUND

The stability and developmental variation of several neurobiological measures in boys with attention-deficit hyperactivity disorder (ADHD) were examined.

METHODS

The prolactin (PRL) response to fenfluramine (FEN) challenge was used to assess central serotonergic (5-HT) functioning in 10 8-11-year-old boys with ADHD. In addition, platelet 5-HT, as well as plasma levels of the catecholamine metabolites 3-methoxy-4-hydroxyphenylglycol (MHPG) and homovanillic acid were ascertained. These neurobiological variables were reassessed in the same children 2-3 years later using the identical procedures.

RESULTS

The PRL response to FEN challenge was the only measure found to be stable across the evaluations (r = .58), although the magnitude of the response decreased significantly with age. Plasma MHPG level significantly increased with age.

CONCLUSIONS

Central 5-HT function, as measured by the PRL response to FEN, may represent a stable trait. The importance of considering developmental factors when interpreting neurobiological data is discussed.

Left and right hemispheric contributions to discourse coherence and cohesion

Linguistic coherence and cohesion were examined in patients with unilateral left brain damage (LBD), unilateral right brain damage (RBD), and normal control (NC) right-handed adults. Groups were matched for age, gender, occupation, and education. Brain-damaged groups did not differ for months post onset or intrahemispheric lesion site. Contrary to previous literature, results indicated that LBDs, all of whom were aphasic, demonstrated impairments in coherence but not cohesion, relative to NCs and RBDs. Surprisingly, among RBDs, overall coherence and cohesion were spared. When the relationship between measures of coherence and cohesion was examined, there were few significant correlations and no systematic patterns. Results support the notion that coherence and cohesion represent coexisting and independent linguistic systems. Further, the findings suggest that descriptions of discourse integrity need to account for the perspective of both the speaker and listener.