Traditional versus modern values,self‐perceived interpersonal factors,and posttraumatic stress in Chinese and German crime victims

Objectives The influence of cultural factors on mental health is not disputed in general – but elaborated research approaches are still lacking. We investigate cultural influences not only by nationality but also by value orientation (modern vs. traditional). A cross‐cultural comparison with Chinese and German crime victims included an assessment of value orientation according to Schwartz's theory ( Schwartz, 1994 ) of personal values. Design Chinese and German adult crime victims were assessed. By means of structural equation multi‐sample analysis, data of the two groups were compared. Method Traditional (conformity, benevolence, customs orientation) and modern values (achievement, hedonism, stimulation), traumatic exposure, posttraumatic stress (PTS), and two self‐perceived interpersonal mediator processes (disclosure intentions, social acknowledgement as a victim) were assessed by self‐report measures in 130 Chinese and 151 German crime victims. Results The two patterns of prediction for PTS differed between the countries: In the German sample both value types but in the Chinese sample only traditional values were directly or indirectly predictive of PTS. Traditional values inhibited social acknowledgement as a victim in China and Germany. In Germany, traditional values were related to increased PTS severity. Modern values predicted social acknowledgement as well as lower symptoms in Germany, but not in China. Conclusions The study shows cultural and interpersonal factors that may contribute to the development of PTSD that are under‐researched in contemporary psychology and psychotherapy.     

Help‐seeking behavior of west African Migrants

In this article, the authors present essential aspects of the help‐seeking behavior with regard to mental health problems of Ghanaian migrants in the Netherlands. Samples of citizens in the general population (n=97) and outpatients treated in mental health care facilities (n=36) were included. Data were acquired by administering a semi‐structured interview. Quantified data were analysed using hierarchical multiple regression analyses and direct (standard) logistic analyses. Help‐seeking pathways are multi‐determined. Being involved in Dutch society may determine an individual's attitude toward health care and the time before taking action. Particularly, socio‐demographic variables (e.g., age, unemployment, urbanicity) and acculturative demands (integrative skills, normative orientation) shape the help‐seeking orientation and service utilization in multiethnic settings. A liaison between mental health services, traditional healers, religious leaders and self‐help groups might therefore benefit patients. By identifying and emphasizing the specific social and acculturation components that facilitate or deter health behaviours, we are better able to implement health care interventions among different ethnic and cultural communities. © 2008 Wiley Periodicals, Inc.     

The behavioral profile of children aged 1–5 years with sex chromosome trisomy (47,XXX, 47,XXY, 47,XYY)

Children with SCT have an increased risk of suboptimal neurodevelopment. Previous studies have shown an elevated risk for neurobehavioral problems in individuals with SCT. However, not much is known about neurobehavioral problems in very young children; knowledge that could help with early identification of children at risk for suboptimal development, and that could help establish targets for early intervention. This study addressed the question of what the behavioral profile of children with SCT aged 1–5 years looks like. In total, 182 children aged 1–5 years participated in this study (N_SCT=87, N_{nonclinical controls} = 95). Recruitment and assessment took place in the Netherlands and the United States. The SCT group was recruited through prospective follow‐up (50%), information seeking parents (31%), and clinical referral (18%). Behavioral profiles were assessed with the child behavior checklist and the ages‐and‐stages social–emotional questionnaire. Levels of parent‐rated problem behavior were higher in children with SCT. Difficulties with overall social–emotional functioning were already present in 1‐year‐olds, and elevated scores were persistent across the full age range. Affective and pervasive developmental behaviors were seen in late toddlerhood and prominent at preschool age. Anxiety, attention deficit, and oppositional defiant behaviors were seen in preschool‐aged children. Within this cross‐sectional study, the developmental trajectory of affective, pervasive developmental, and oppositional defiant behaviors seemed to be different for SCT children than nonclinical controls. Collectively, these results demonstrate the importance of behavioral screening for behavioral problems in routine clinical care for children with SCT from a young age. Social–emotional problems may require special attention, as these problems seem most prominent, showing increased risk across the full age range, and with these problems occurring regardless of the timing of diagnosis, and across all three SCT karyotypes.     

Religiosity,spirituality, and help‐seeking among Filipino Americans: Religious clergy or mental health professionals?

Data from structured interviews with 2,285 respondents for the Filipino American Community Epidemiological Survey (FACES) were used to examine help‐seeking for emotional distress among Filipino Americans. The influence of religious affiliation, religiosity, and spirituality upon help‐seeking from religious clergy and mental health professionals was assessed after controlling for need (e.g., negative life events, SCL‐90R scores, and somatic symptoms), demographic (e.g., age, gender, marital status, education, county of residence, generational status, and insurance coverage), and cultural variables (e.g., loss of face and language abilities). Rates of help‐seeking from religious clergy versus mental health professionals were comparable (2.5% vs. 2.9%). High religiosity was associated with more help‐seeking from religious clergy but not less help‐seeking from mental health professionals, whereas high spirituality was associated with less mental health help‐seeking. Implications for understanding how religious variables affect help‐seeking were explored. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 675–689, 2004.     

Seeking help for illness: the roles of cultural orientation and illness cognition

A group of 112 Chinese Singaporean undergraduates and 109 of their parents completed a questionnaire on disease perceptions, help-seeking behaviour, Chinese cultural values and personal background. Analysis of these data using structural equation modelling indicated that individuals high in Chinese cultural orientation were more likely to describe diseases using Chinese health concepts and less likely to describe diseases in terms of physical causality or chronicity. Illness concepts, in turn, related to illness behaviour in that participants making greater use of Chinese health concepts were significantly more likely to state that they would seek treatment from a sinseh (practitioner of Chinese medicine) and less likely to go to an allopathic physician whereas participants tending to describe diseases as physically caused indicated greater likelihood of seeking help from an allopathic physician. Also, cultural orientation was positively related to seeking help from a sinseh, independent of its relationship to illness concepts.     

Relationships with adults as predictors of substance use,gang involvement,and threats to safety among disadvantaged urban high‐school adolescents

Using a resilience framework, the authors examined the protective effects of parental support, self‐disclosure to parents, parent‐initiated monitoring of adolescent behavior, and relationships with school personnel on three critical problems of adolescents: substance use, gang involvement, and perceived threats to safety at school. The sample consisted of 342 ethnically diverse high‐school students in an economically disadvantaged urban area in the southwestern United States. The regression analyses controlled for academic performance, poor anger management, risk‐seeking propensities, co‐occurring substance use, and co‐occurring gang involvement. Interactions as well as main effects were examined. The specific protective roles of all four adult relationships were identified with respect to problematic outcomes. Adolescent self‐disclosure to parents, a variable rarely examined in resilience research, was associated with less chance of substance use for two high‐risk groups: those already involved with gangs, and those with high risk‐seeking tendencies. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 1053–1071, 2007.     

Promoting informal and professional help‐seeking for adolescent dating violence

The present study examined factors that differentiate adolescents with varied intentions of informal and professional help seeking for dating violence. Help‐seeking intentions among 518 ethnically diverse adolescents from a rural South Carolina county who participated in a longitudinal study of teen dating violence were categorized into 3 groups: adolescents unlikely to seek any help, adolescents likely to seek only informal help, and adolescents likely to seek informal and professional help. Multinomial logistic regression found that gender, family functioning, problem‐solving competency, dating status, having an adult to talk to about a dating relationship, and acceptability of family violence significantly predicted membership in the help‐seeking groups. Implications for promoting informal and professional help seeking and recommendations for future research are discussed.     

Help‐seeking intentions for breast‐cancer symptoms: A comparison of the self‐regulation model and the theory of planned behaviour

Purpose: Delays in seeking help for symptoms have been found to be associated with poorer outcome in breast‐cancer patients. This study explores symptom perceptions and health beliefs as predictors of intentions to seek medical help in a general female population. The utility of the self‐regulation model of illness cognition and the theory of planned behaviour were examined in predicting help‐seeking intentions for potential symptoms of breast cancer in a general population sample. Methods: A general population sample of 546 women completed a postal questionnaire comprising items examining components of the self‐regulation model and the theory of planned behaviour. Help‐seeking intention was determined by asking participants to rate the likelihood of visiting their GP for a range of breast symptoms. Results: Hierarchical multiple regression analysis revealed that the cognitive component of the self‐regulation model accounted for approximately 22% of the variance in help‐seeking intention. Identity (β = 0.45, p < .001) emerged as a significant predictor of intention to seek help. Inclusion of the components of the theory of planned behaviour accounted for an additional 7% of the variance; the significant predictors were attitude to help‐seeking (β = 0.19, p <.001) and perceived behavioural control (β = 0.12, p <.01). Conclusions: Intention to seek medical help for a potential breast‐cancer symptom may be mediated, partly, by cognitive representations of the identity and consequences of breast cancer and by attitudes towards help‐seeking and perceived behavioural control. Although less than one‐third of the variance was accounted for, these results have important implications for future research (in terms of identifying which variables should be examined) and for the development of a model of help‐seeking behaviour in women with breast‐cancer symptoms.     

INVOLVING PARENTS IN A COMMUNITY‐BASED,CULTURALLY GROUNDED MENTAL HEALTH INTERVENTION FOR AMERICAN INDIAN YOUTH: PARENT PERSPECTIVES,CHALLENGES, AND RESULTS

An important predictor of youth well‐being and resilience is the presence of nurturing adults in a youth's life. Parents are ideally situated to fulfill this role but often face challenges and stressors that impede their ability to provide adequate support and guidance. American Indian parents may also be affected by intergenerational transmission of trauma and loss of traditional parenting practices, as a result of forced boarding school and/or relocation. Members of a community‐university partnership sought to interrupt cycles of violence and poor mental health of youth through a culturally‐grounded intervention for youth and their parents that focused on healing historical trauma, strengthening positive parenting practices and social skills, reconnecting to traditional cultural knowledge, and improving parent‐child relationships/communication. This article describes parental involvement and its challenges and provides mixed‐method results for 10 parents related to enculturation, parenting practices, parent‐child communication, family cohesion, historical loss and associated symptoms, and community involvement.     

Maternal and paternal effects on offspring internalizing problems: Results from genetic and family‐based analyses

It is unclear to what extent parental influences on the development of internalizing problems in offspring are explained by indirect genetic effects, reflected in the environment provided by the parent, in addition to the genes transmitted from parent to child. In this study, these effects were investigated using two innovative methods in a large birth cohort. Using maternal‐effects genome complex trait analysis (M‐GCTA), the effects of offspring genotype, maternal or paternal genotypes, and their covariance on offspring internalizing problems were estimated in 3,801 mother–father–child genotyped trios. Next, estimated genetic correlations within pedigree data, including 10,688 children, were used to estimate additive genetic effects, maternal and paternal genetic effects, and a shared family effect using linear mixed effects modeling. There were no significant maternal or paternal genetic effects on offspring anxiety or depressive symptoms at age 8, beyond the effects transmitted via the genetic pathway between parents and children. However, indirect maternal genetic effects explained a small, but nonsignificant, proportion of variance in childhood depressive symptoms in both the M‐GCTA (~4%) and pedigree (~8%) analyses. Our results suggest that parental effects on offspring internalizing problems are predominantly due to transmitted genetic variants, rather than the indirect effect of parental genes via the environment.     

Over- and undercontrolled clinic referral problems of Jamaican and American children and adolescents: the culture general and the culture specific

Child behavior problems and corresponding clinic referral patterns may be significantly influenced by cultural factors. Prevailing values and childrearing practices within a culture may discourage development of some child problems while fostering others. We explored this possibility, focusing on clinic referral problems of two different societies: (a) Jamaica, where the Afro-British culture discourages child aggression and other undercontrolled behavior and possibly fosters inhibition and other overcontrolled behavior, and (b) the United States, where undercontrolled child behavior is seemingly more generally accepted. We coded clinic-referred problems listed by parents of Jamaican and American youngsters (N = 720). Cross-cultural differences were striking: Overcontrolled problems were noted more often for Jamaican than American youngsters, whereas the converse was true for undercontrolled problems. These and other findings suggest that factors such as culture and sex may be linked to substantial differences in the problems for which youngsters of different countries are treated in clinics.     

Marital Adjustment,Marital Discord Over Childrearing,and Child Behavior Problems: Moderating Effects of Child Age

Examined whether marital discord over childrearing contributes to child behavior problems after taking into account general marital adjustment, and if child age moderates associations between child behavior problems and either general marital adjustment or marital discord over childrearing. Participants were 146 two-parent families seeking services for their child's (4 to 9 years of age) conduct problems. Data on marital functioning and child behavior problems were collected from both parents. Mothers' and fathers' reports of marital discord over childrearing related positively to child externalizing problems after accounting for general marital adjustment. Child age moderated associations between fathers' reports of general marital adjustment and both internalizing and externalizing child problems, with associations being stronger in families with younger children. The discussion highlights the role that developmental factors may play in understanding the link between marital and child behavior problems in clinic-referred families.     

Family‐ and community‐level predictors of parent support seeking

The influences of community‐ and family‐level socio‐demographic factors on parent formal and informal support‐seeking activities were examined. Data analyzed were collected from 1,260 parents of sixth graders from 26 rural Iowa communities. Hierarchical linear modeling results indicated that both family‐ and community‐level factors were significant predictors of parent support seeking. Findings at the family level indicated that household income, parent gender, and number of children were significantly predictive of informal support seeking; parent education and parent gender were significantly predictive of formal support seeking. In addition, significant community population size effects on informal parent support seeking were found. © 2002 John Wiley & Sons, Inc.     

EXPLORING THE ROLE OF ETHNIC IDENTITY IN FAMILY FUNCTIONING AMONG LOW‐INCOME PARENTS

The majority of research on ethnic identity (EI) has highlighted its role in mitigating risks associated with racial discrimination; however, discrimination is only one of many stressors that ethnic minority individuals face. The current study examined the relationships between EI, emotional distress, and the parent–child relationship among ethnically diverse, low‐income parents. Results indicated significant associations between EI and emotional distress, and EI and the parent–child relationship for African American parents, but not for their Latino or European American counterparts. Furthermore, when examined separately by gender, stronger EI buffered the impact of economic hardship on emotional distress for African American fathers. The current study provides preliminary evidence that EI plays an important role in the lives of ethnically diverse parents who are facing economic hardship. Methods for embracing and fostering EI may be valuable to incorporate into therapeutic services and strength‐based intervention programming, especially when serving low‐income African American individuals.     

Predicting Colonoscopy Screening Behavior and Future Screening Intentions for African Americans Older than 50 Years

Abstract

African Americans experience a disproportionate burden of morbidity and mortality from colorectal cancer, which may be due to low adherence to screening recommendations. Previous studies have found relationships between decision-making factors and screening behavior, but few have looked at both cognitive and affective factors or within a specifically African American sample. To better understand determinants that drive screening behavior, this study examines affective, cognitive, and social variables as predictors of colonoscopy in an age-eligible African American population. Participants completed surveys assessing affective associations with colonoscopy, perceived benefits and barriers, self-efficacy, knowledge, fear of colonoscopy, perceived risk, and colorectal cancer worry and fear. Regression analysis was used to model decision-making constructs as predictors of screening behavior/intentions. Affective, cognitive, and health care experience variables predicted colonoscopy completion and intentions. Provider-level factors and previous cancer screenings predicted prior screening only, but not intentions. Affective and cognitive components of perceived risk were associated with decreased likelihood of colonoscopy behavior, but increased likelihood of colonoscopy intentions. These findings suggest that colonoscopy decision making involves a complex array of both cognitive and affective determinants. This work extends our knowledge of colorectal cancer screening decision making by evaluating the effects of these multiple determinants on screening behavior in an African American sample. Future work exploring the interplay of affect and cognitions as influences on colonoscopy decision making and how health care experiences may moderate this effect is needed to develop effective intervention approaches and reduce screening disparities.     

Initial evaluation of a cultural approach to implementation of evidence‐based parenting interventions in American Indian communities

The current investigation puts forth the authors' conceptualization of a cultural approach to implementing evidence‐based practices with American Indian (AI) families. Their approach involves two phases, the motivational phase, which sets an historical context for current difficulties; and the intervention phase, which links evidence‐based skills with cultural traditions, beliefs, and values. Herein, they present preliminary evidence for the efficacy of the intervention phase, overlaid onto the Incredible Years parenting program (Webster‐Stratton, 1992). Forty‐nine families with American Indian children, ages 3–11 (26 boys), participated in the study; all families participated in the motivational phase and were subsequently randomized to the culturally linked intervention or a control condition. Significant pre‐ and postimprovements in parenting and child behavior were observed in the intervention group. Moreover, a majority of participants reported high levels of satisfaction with the intervention. Results are discussed in relation to approaches to respectful implementation of mainstream, evidence‐based interventions in Indian Country. © 2009 Wiley Periodicals, Inc.     

Family‐Based Therapy for Parent–Child Reunification

Children in highly conflicted, divorced families can become triangulated and polarized in their relationships with their parents. In time, this can lead to a child refusing to have a relationship with a parent, refusing for example, to see or talk to him or her. This access refusal can sometimes become extended, lasting months to years. When this occurs, the courts may request professional involvement to help facilitate parent–child reunification. This article outlines a family‐based treatment model for parent–child reunification cases. This family‐based treatment incorporates treatment goals for each family member and each family member is asked to be a part of the solution in resolving the family's problems. I provide a case illustration as well as helpful tips for treating these families.     

An open‐ended primary‐care group intervention for insomnia based on a self‐help book – A randomized controlled trial and 4‐year follow‐up

Chronic insomnia is a common and burdensome problem for patients seeking primary care. Cognitive behavioural therapy has been shown to be effective for insomnia, also when presented with co‐morbidities, but access to sleep therapists is limited. Group‐treatment and self‐administered treatment via self‐help books have both been shown to be efficacious treatment options, and the present study aimed to evaluate the effect of an open‐ended group intervention based on a self‐help book for insomnia, adapted to fit a primary‐care setting. Forty primary‐care patients with insomnia (mean age 55 years, 80% women) were randomized to the open‐ended group intervention based on a cognitive behavioural therapy for insomnia self‐help book or to a care as usual/wait‐list control condition. Results show high attendance to group sessions and high treatment satisfaction. Participants in the control group later received the self‐help book, but without the group intervention. The book‐based group treatment resulted in significantly improved insomnia severity, as well as shorter sleep‐onset latency, less wake time after sleep onset, and less use of sleep medication compared with treatment as usual. The improvements were sustained at a 4‐year follow‐up assessment. A secondary analysis found a significant advantage of the combination of the book and the open‐ended group intervention compared with when the initial control group later used only the self‐help book. An open‐ended treatment group based on a self‐help book for insomnia thus seems to be an effective and feasible intervention for chronic insomnia in primary‐care settings.     

The short‐term impact of a problem‐solving skills programme for Iranian parents

Background: The ability of children to solve problems is an important influence on the social‐cognitive development of children. Parents and children who use problem‐solving strategies display more positive parent‐child relationships. It follows that parents will be more effective in promoting the children's development and healthy parent‐child relationships if they are skilled in problem‐solving strategies and encourage their children to use these strategies. Aim: The aim of the present study was to evaluate the short‐term efficacy of a problem‐solving skills program for Iranian parents (the ‘Raising a Thinking Child’ program) on the parent‐child relationship. Materials and method: Sixty‐four mothers of 4–8 year‐old children participated voluntarily in 12 2‐hour weekly workshops over a three month period. Parents were taught a procedure for problem‐solving and provided with the opportunity to consider how the procedure could be applied in response to challenging behaviors of their children. The problem‐solving strategies were taught as an alternative to ineffective approaches such as punishing and reprimanding. Results: Results indicated that teaching problem‐solving skills to parents had a positive influence on a number of dimensions of parenting as measured by the Parent Child Relationship Inventory. Conclusion: Parents who attended the program felt more supported, more involved with their children and better able to balance limit setting and child autonomy.