The acculturation gap-distress hypothesis among high-risk Mexican American families.

The authors tested the acculturation gap-distress hypothesis by examining whether parent-adolescent acculturation gaps were associated with greater conflict and youth conduct problems among 260 high-risk Mexican American families. The authors operationalized acculturation gaps in 2 ways: parent-youth mismatches in acculturation style, and parent-youth discrepancies in acculturation toward both mainstream and heritage cultures. Acculturation gaps were common, but results of hierarchical regression analyses indicated that parent-youth discrepancies in acculturation toward mainstream and heritage cultures were not related to increased conflict or youth conduct problems. Conduct problems were no higher in families in which the adolescent was more aligned with mainstream culture than the parent. Unexpectedly, the authors found more youth conduct problems in families in which the youth was more aligned with traditional culture than the parent. The results call into question the assumption that the more rapid acculturation of adolescents to American culture inevitably leads to distress in minority families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent sibling relationships in Mexican American families: Exploring the role of familism.

To address a significant gap in the literature on normative processes in minority families, the authors studied adolescents' sibling relationships in two-parent Mexican American families and explored connections between sibling relationship characteristics and familism. Participants were 246 adolescent Mexican American sibling pairs who participated in (a) home interviews during which adolescents described their sibling relationships and familism values and (b) a series of 7 nightly phone calls during which adolescents reported their daily activities, including time spent with siblings and family members. Siblings described their relationships as both intimate and conflictual, and daily activity data revealed that they spent an average of 17.2 hr per 7 days in shared activities. Sibling relationship qualities were linked to familism values and practices, and stronger patterns of association emerged for sisters than brothers. Discussion highlights the significance of studying the processes that underlie within-group variations among families of different cultural backgrounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expanding the concept of acculturation in Mexican American rehabilitation psychology research and practice.

The acculturation process is increasingly being viewed as an important variable that provides a context for understanding Mexican American health disparities. Although rehabilitation psychologists have noted the importance of utilizing acculturation in research and practice, scholars continue to use out-dated conceptualizations and models of acculturation. Objectives: The authors provide a brief overview of current trends in acculturation theory and research. Limitations of current rehabilitation research and how acculturation theory can help explain Mexican American health outcomes are discussed. Finally, recommendations for rehabilitation research and practice are provided. Conclusions: The authors recommend that rehabilitation scholars develop and test theoretical models that incorporate multiple dimensions of acculturation in order to understand how it influences Mexican American health outcomes. Rehabilitation professionals should incorporate acculturation theory and culturally informed interventions into rehabilitation practice with Mexican Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting self-efficacy and parenting practices over time in Mexican American families.

Drawing on social cognitive theory, this study used a longitudinal cross-lagged panel design and a structural equation modeling approach to evaluate parenting self-efficacy's reciprocal and causal associations with parents' positive control practices over time to predict adolescents' conduct problems. Data were obtained from teachers, mothers, and adolescents in 189 Mexican American families living in the southwest United States. After accounting for contemporaneous reciprocal relationships between parenting self-efficacy (PSE) and positive control, results indicated that parenting self-efficacy predicted future positive control practices rather than the reverse. PSE also showed direct effects on decreased adolescent conduct problems. PSE functioned in an antecedent causal role in relation to parents' positive control practices and adolescents' conduct problems in this sample. These results support the cross-cultural applicability of social cognitive theory to parenting in Mexican American families. An implication is that parenting interventions aimed at preventing adolescent conduct problems need to focus on elevating the PSE of Mexican American parents with low levels of PSE. In addition, future research should seek to specify the most effective strategies for enhancing PSE. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of psychologists in the care of Iraq and Afghanistan veterans in primary care settings.

Although military personnel serving in Iraq and Afghanistan are at high risk of developing mental health problems, many report significant barriers to care and few seek help. Integrated primary care is a comprehensive model of health care that aims to improve access to care and provides a framework to assess and meet the complex psychiatric needs of newly returning veterans by embedding mental health specialists within primary care. We describe the role of psychologists in a Department of Veterans Affairs (VA) integrated primary care clinic that serves veterans of Iraq and Afghanistan. Psychologists based in primary care can assist veterans with reintegration to civilian life by providing rapid mental health assessment, normalizing re-adjustment concerns, planning for veterans’ safety, implementing brief interventions within primary care, facilitating transition to additional mental health care, and informing veterans of other available psychosocial services. A case example demonstrating the psychologist’s role highlights the benefits of an integrated care model. Implications of employing this model include reduction of symptoms and impairment by reducing stigma and barriers to seeking mental health care, increased motivation to engage in treatment, and implementation of early interventions. This model may also be beneficial in the civilian health care sector with groups that are at high risk for mental health problems, yet experience barriers to care, particularly stigma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-centered culturally sensitive health care: Model testing and refinement.

Objectives: This article presents the results of an empirical test of a literature-based Patient-Centered Culturally Sensitive Health Care Model. The model was developed to explain and improve health care for ethnically diverse patients seen in community-based primary care clinics. Design: Samples of predominantly low-income African American (n = 110) and non-Hispanic White American (n = 119) patients were recruited to complete questionnaires about their perceived health care provider cultural sensitivity and adherence to their provider's treatment regimen recommendations. Main Outcome Measures: Patients completed written measures of their perceived provider cultural sensitivity, trust in provider, interpersonal control, satisfaction with their health care provider, physical stress, and adherence to provider-recommended treatment regimen variables (i.e., engagement in a health promoting lifestyle, and dietary and medication adherence). Results: Two-group path analyses revealed significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations, with some differences in associations emerging by race/ethnicity. Conclusion: The findings provide empirical support for the potential usefulness of the Patient-Centered Culturally Sensitive Health Care Model for explaining the linkage between the provision of patient-centered, culturally sensitive health care, and the health behaviors and outcomes of patients who experience such care. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Bridging the acculturation gap: Parent-child relationship quality as a moderator in Mexican American families.

The authors examined the degree to which disparities in parent and child acculturation are linked to both family and child adjustment. With a sample of 1st- and 2nd-generation Mexican American children, acculturation and parent-child relationship quality at 5th grade, and parent-child conflict, child internalizing, and child externalizing at 7th grade were measured. Acculturation gaps with fathers were found to be related to later father-child conflict as well as internalizing and externalizing outcomes. Many of the associations between father-child acculturation gaps and outcomes were moderated by the child's report of the relationship quality between the child and his or her father. Father-child acculturation gaps were associated with negative outcomes only when children reported a poor relationship with their fathers. Mother-child acculturation gaps were not associated with mother-child conflict or adjustment indices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived racial/ethnic discrimination, posttraumatic stress symptoms, and health risk behaviors among Mexican American adolescents.

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An introduction to psychologists treating medically ill patients: Competent practice and seeking credentials in organized health care settings for routine or incidental practice.

Psychology has been recognized as a health care science and profession, and psychologists have been working clinically with medically ill patients and within organized health care settings and hospitals for decades. The potentially daunting environment of organized health care should be seen by psychology as an opportunity to further develop and expand its scope of practice. With knowledge of that environment's rules, regulations, ethics, bylaws, and traditions, the clinically competent psychologist who is first seeking to practice in hospitals should succeed alongside psychologists with busy practices who are already exclusively or occasionally within an organized health care setting or medical facility. This article reviews issues of competency, credentialing, privileges, bylaws, and practice expansion to guide psychologists toward a successful hospital practice with medically ill patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparing psychology and psychologists for new health care markets.

Because our training models in Clinical Psychology have not kept pace with the rapid changes in the health care marketplace, we may be in danger of preparing psychologists for markets that no longer exist. The next generations of psychologists will require the skills of the entrepreneur and the leader in addition to a range of core clinical skills. At the same time, our profession's historic commitment to science as the best epistemic game in town may founder if we fail to pay better attention to knowledge translation (i.e., how to move scientific findings expeditiously from the laboratory into practice). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parenting Style of Mexican, Mexican American, and Caucasian-Non-Hispanic Families: Social Context and Cultural Influences.

To begin accounting for cultural and contextual factors related to child rearing in Mexican-descent (MD; Mexican American and Mexican immigrant) families in the United States, the current study examined parenting practices in 2-parent families of Mexican, MD, and Caucasian-non-Hispanic (CNH) parents. Parents in all groups reported using authoritative practices more often than authoritarian strategies. MD parents reported greater use of authoritarian practices than Mexican and CNH parents. Results suggest that previously found cultural variations in parenting between MD parents and CNH parents may be more related to the ecological context of MD families than to an affiliation with Mexican culture. Clinicians should explore the positive qualities of authoritative parenting in MD families along with the potential motivations for using authoritarian strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adapting cognitive-behavioral therapy for Mexican American students with anxiety disorders: Recommendations for school psychologists.

Mexican American students are the fastest growing group in U.S. public schools. There is a growing body of research indicating that Mexican American families underutilize mental health services and are more likely to drop out of care prematurely when they do seek help. These findings may indicate that our health care system is not providing ethnic minorities with culturally competent care. Although cognitive?behavioral interventions are considered to be evidence-based treatments for child anxiety disorders, previous protocols have not taken cultural factors into account. This article discusses how to adapt cognitive?behavioral therapy (CBT) for Mexican American students with anxiety disorders. Working within the Psychotherapy Adaptation and Modification Framework (PAMF), this article offers adaptation principles that may guide school psychologists in implementing CBT strategies when working with Mexican American youth and their families. A case study is provided illustrating how cultural modifications of CBT can lead to positive outcomes for Mexican American students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural influences on positive father involvement in two-parent Mexican-origin families.

A growing body of research documents the importance of positive father involvement in children's development. However, research on fathers in Latino families is sparse, and research contextualizing the father–child relationship within a cultural framework is needed. The present study examined how fathers' cultural practices and values predicted their fifth-grade children's report of positive father involvement in a sample of 450 two-parent Mexican-origin families. Predictors included Spanish- and English-language use, Mexican and American cultural values, and positive machismo (i.e., culturally related attitudes about the father's role within the family). Positive father involvement was measured by the child's report of his or her father's monitoring, educational involvement, and warmth. Latent variable regression analyses showed that fathers' machismo attitudes were positively related to children's report of positive father involvement and that this association was similar across boys and girls. The results of this study suggest an important association between fathers' cultural values about men's roles and responsibilities within a family and their children's perception of positive fathering. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

At the starting gate: Research and theory on families and somatic health.

Reviews the books, Family's impact on health: A critical review and annotated bibliography by T. L. Campbell (see record 1987-34495-001); Family-centered medical care: A clinical casebook edited by W. J. Doherty and M. A. Baird (see record 1987-97755-000); and Health, illness, and families edited by D. C. Turk and R. D. Kerns (1985). The field of families and somatic health is a vital one; its research findings have implications for both clinical practice and public policy. Under the rubric of families and health lie a diverse set of topics that span the entire life cycle. They include among others: (a) the impact of family factors on somatic health outcome and conversely the influence of somatic health on family functioning, (b) the effect of family factors on compliance to medical regimens and the adoption of beneficial health practices, (c) family interventions designed to promote health and/or help families deal with chronic disease or acute illness, and (d) the family's influence on health utilization behaviors. The books reviewed here cover these topics quite well. When considered as a group, these three volumes inform the reader about the state of the art of families and health, and suggest future directions. The three volumes reviewed here, taken together, demonstrate the challenging nature of this area of work and provide a useful point of departure for further accomplishments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychology of health and health care: A Canadian perspective.

Reviews the book, The psychology of health and health care: A Canadian perspective by Gary Poole, Deborah Hunt Matheson, and David N. Cox (2001). This book is a timely introductory text that aims to situate the rapidly expanding field of health psychology within the geographic, socio-demographic, and empirical landscape of Canada. This textbook would be appropriate for beginning and intermediate undergraduate students across a range of disciplines, including psychology, public health, and nursing. As such, it has a number of features to commend it. It is written in a clear and concise style, with explanatory tracks guiding the reader step by step through each new concept. In keeping with health psychology's applied focus, web sites for important resources are provided and sample case studies are integrated with key concepts throughout each chapter. Finally, the up-to-date coverage of Canadian health statistics and research publications is a delight for those of us who have been struggling to find texts that reflect the unique ways in which we view, structure, fund, administer, and research health psychology and health care in this country. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role functions of pediatric and health psychologists in health care settings.

686 pediatric and health psychologists completed questionnaires requesting background information concerning years of experience, current work settings, graduate training, and professional identification. Ss were also asked to describe services and functions they performed, difficulties they encountered, and general consultation goals. Results suggest that both groups are involved in a wide range of diagnostic, treatment, and consultative activities in health care settings and that there are many similarities in the ways they conceptualize their roles and how they function. However, pediatric psychologists were especially involved in clinical assessment activities, whereas research was a high priority for health psychologists. Other aspects of the roles, functions, and activities of these 2 groups are described. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Access to health care services among people with rehabilitation needs receiving Medicaid.

Objective: To investigate access to care for individuals with rehabilitation-related conditions receiving fee-for-service Medicaid. Study Design: Telephone survey. Participants: One hundred thirty-eight individuals with spinal cord injury (SCI), brain injury (BI), or stroke. Main Outcome Measures: Frequency of difficulty or failure to access medical services, perceived effect on health, services most difficult to access, and reasons for difficulty. Results: People with SCI reported the most frequent difficulty accessing services (87%), followed by persons with BI (79%) and stroke (65%). In a subgroup of respondents, 60% reported failure to receive at least 1 service; 81% reported that access difficulties affected health or daily routine. Conclusions: People with rehabilitation-related disabilities may experience greater barriers to needed services than the larger population of persons with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-language measurement equivalence of parenting measures for use with Mexican American populations.

Increasing diversity among families in the United States often necessitates the translation of common measures into various languages. However, even when great care is taken during translations, empirical evaluations of measurement equivalence are necessary. The current study demonstrates the analytic techniques researchers should use to evaluate the measurement equivalence of translated measures. To this end we investigated the cross-language measurement equivalence of several common parenting measures in a sample of 749 Mexican American families. The item invariance results indicated similarity of factor structures across language groups for each of the parenting measures for both mothers and children. Construct validity tests indicated similar slope relations between each of the 4 parenting measures and the outcomes across the 2 language groups for both mothers and children. Equivalence in intercepts, however, was only achieved for some outcomes. These findings indicate that the use of these measures in both within-group and between-group analyses based on correlation/covariance structure is defensible, but researchers are cautioned against interpretations of mean level differences across these language groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)