The Conceptualization of Depression and Acculturative Stress among Latino Immigrants: A Comparison of Scores from Non-Hispanic Whites and Persons of Mexican Origin on the Center for Epidemiologic Studies Depression Scale - Revised (CESD-R)

This dissertation examines and compares the influence of acculturative stress on the experience of depressive symptoms among Non-Hispanic Whites and persons of Mexican origin. The objectives of this dissertation are threefold: First, to develop an expanded and integrated explanatory model of Latino acculturative stress that accounts for culture, stress and coping, cognitive appraisal, timing, and family and neighborhood factors; second, to evaluate the reliability and validity evidence of the English language version of the CESD-R; and third, to evaluate the reliability and validity evidence of the Spanish language version of the CESD-R. The first manuscript posits an explanatory model that expands upon and integrates work by Berry (2006) and most notably adds the dimension of family and neighborhood. Recent research findings on Latino immigrant depression point toward the importance of understanding and leveraging the protective nature of neighborhood and family (Breslau, 2011; Shell, Peek, & Eschbach, 2013). The second manuscript evaluates the validity and reliability evidence of the English language version of the CESD-R. The results of an EFA, CFAs, and a multiple-group CFA of the English version of the CESD-R suggest that a 15-item version of the CESD-R best fit the study data. The final two-factor solution of negative mood and functional impairment and suicide, fit the data well. The third manuscript evaluates the reliability and validity evidence of the Spanish language version of the CESD-R. The scores of the Spanish Language version of the CESD-R fit the same CESD-R factor structure of Manuscript II. The results support the use of the 15-item version of the CESD-R with a Spanish speaking sample. This suggests that despite cultural differences, there are common cross-cultural components of depression that relate to negative mood and functional impairment and suicide.Doctor of Philosoph

The use of focus groups in the development of the PROMIS pediatrics item bank

To understand differences in perceptions of patient reported outcome domains between children with asthma and children from the general population. We used this information in the development of patient-reported outcome items for the Patient Reported Outcomes Measurement Information System Pediatrics project

Problem Drinking among Mexican-Americans: The Influence of Nativity and Neighborhood Context?

We examined the influence of nativity and community context (Hispanic neighborhood concentration) on two measures of problem drinking among Mexican-Americans

Problem Drinking among Mexican-Americans: The Influence of Nativity and Neighborhood Context?

PURPOSE: We examined the influence of nativity and community context (Hispanic neighborhood concentration) on two measures of problem drinking among Mexican-Americans. DESIGN: Cross-sectional study SETTING: Texas City Stress and Health Study conducted in Texas City, Texas during 2004–2006. PARTICIPANTS: A total of 1435 Mexican-Americans aged 25 years and older. MEASURES: Binge drinking (≥ 6 drinks per occasion by men and ≥ 4 drinks per occasion by women) and scoring positive on the CAGE (a four-item clinical measure of problem drinking) as dependent variables. Key independent variables included a measure of language acculturation, proportion of Hispanics in the participant's neighborhood according to 2000 U.S. Census data, and being foreign-born compared with being U.S.-born. ANALYSIS: Logistic regression analysis was used to predict being a binge drinker and being positive on the CAGE. RESULTS: Foreign-born women were less likely to be binge drinkers than U.S.-born women. Nativity was not significant among men. Moreover women were less likely to be binge drinkers if they lived in heavily Hispanic neighborhoods. No such effect was found among men. Similar results were obtained with the CAGE. CONCLUSIONS: We found a powerful influence of nativity (being U.S.-born compared with foreign born) and neighborhood Hispanic concentration on problem drinking among women but not among men. It is likely that cultural norms in heavily Hispanic environments discourage problem drinking among women but not among men