Anne E. Norris

Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients.

To clarify the relationships between physical, and psychosocial components of chronic pain, a path analytic model was tested conceptualizing self efficacy as a mediator of disability. In turn, disability was hypothesized to mediate depression. This model could help explain the circumstances under which disability develops and why so many chronic pain patients become depressed. Questionnaires from 126 chronic pain patients (without prior depression) were reviewed from three pain clinics. Hypothesized and alternate models were tested using separate regression equations to identified models which best fit these data. Regression analysis supported that self efficacy partially mediates the relationship between pain intensity and disability. This model accounted for 47% of the explained variance in disability (P < 0.001). Six additional variables that were significantly related to disability in preliminary analysis, added to the explained variance in disability (R2 = 0.56), with gender and pain location paths remaining significant. In separate regression analyses, disability was found to partially mediate the relationship between pain intensity and depression (b = 0.47-0.33). This model accounted for 26% of the explained variance in depression. The addition of self efficacy to this model supported it as a stronger mediator (R2 = 0.32), and suggested that support for disability as a mediator of depression was a spurious finding. Both pain intensity and self efficacy contribute to the development of disability and depression in patients with chronic pain. Therefore, the lack of belief in ones own ability to manage pain, cope and function despite persistent pain, is a significant predictor of the extent to which individuals with chronic pain become disabled and/or depressed. Nevertheless, these mediators did not eliminate the strong impact that high pain intensity has on disability and depression. Therefore, therapy should target multiple goals, including: pain reduction, functional improvement and the enhancement of self efficacy beliefs.

Resilience, Stress, and Depression among Russian Immigrants to Israel

This article reports the relationships between resilience, demographic characteristics, immigration demands, and depression in a sample of 450 adult Russian immigrants to Israel. Contrary to theories of how resilience is related to psychological outcomes, no support was found for resilience modifying or mediating the relationship between the demands of immigration and depression. Resilience did, however, increase the risk of not being depressed by about two-fold (p < .0001).

Urban Hispanic adolescents and young adults: Relationship of acculturation to sexual behavior

As Hispanic persons in the U.S. are exposed to U.S. culture, changes may occur in values, attitudes, and behavior. This process of change has been called acculturation. The objectives of this research were to describe the sexual behavior of low income, urban Hispanic youth in Detroit and to evaluate the relationship of acculturation to sexual behavior. Data were drawn from a household probability sample of 711 low income, urban youth. The relationship of acculturation to sexual activity, types of intercourse, number and ethnicity of partners, condom use, and use of other methods were estimated for never married men and women. Level of acculturation was associated with sexual behavior. Specifically, women with high acculturation were much more likely to have had at least one sexual partner in the last year, to have non‐Hispanic partners, to have oral and anal sex, and to have used condoms. For men, high acculturation was positively associated with oral sex and having non‐Hispanic partners. Use of contracep...

Sexual experiences and condom use of heterosexual, low-income African American and Hispanic youth practicing relative monogamy, serial monogamy, and nonmonogamy.

BACKGROUND AND OBJECTIVES To describe (a) demographic characteristics, (b) sexual history, (c) perceived HIV susceptibility, and (d) current sexual behavior, condom use, and alcohol and marijuana use of heterosexual, low-income African American and Hispanic youth categorized as relatively monogamous (n = 577), serial monogamous (n = 171), or nonmonogamous (n = 278). STUDY DESIGN Data were drawn from personal interviews with a probability sample of low-income youth, age 15 to 24 years, conducted in Detroit in 1991. RESULTS Many group differences were found. For example, relatively monogamous youth were most likely to be female and Hispanic and to have engaged in unprotected intercourse. Serial monogamous youth were younger and most likely to have used condoms at last intercourse. Nonmonogamous youth initiated intercourse earlier and were most likely to have experienced oral and anal intercourse and to have used alcohol and marijuana. CONCLUSION Risk reduction programs may need to be tailored differently to accommodate the needs of these three distinct subgroups of youth.

Predicting psychological distress among former Soviet immigrants.

This study investigated whether age, gender, marital status, education, employ ment, length of time in the U.S. and immigration demands (novelty, occupation, language, discrimination, loss, and not feeling at home) were predictors of psychological distress in a sample of 1,647 former Soviet immigrants. Multiple regression analysis indicated that the combined model of demographic and demand of immigration variables was significant. Results indicated that women, older immigrants, those with less than a college education, and those with greater immigration demands related to novelty, language, discrimination, loss, and not feeling at home were most distressed.

Development and psychometric evaluation of the Demands of Immigration Scale.

The Demands of Immigration Scale (DI) measures demands associated with immigration, including loss, novelty, occupational adjustment, language accommodation, discrimination, and not feeling at home in the resettlement country. The DI scale was evaluated in a sample of 1,647 immigrants from the former Soviet Union who had resided in the United States from a few months to 20 years. Confirmatory factor analysis supported the proposed factor model. The DI subscales were internally consistent and had good test-retest reliability. Support for concurrent validity was demonstrated by correlations in the expected direction between the DI total and subscale scores and measures of depression and somatization. Support for discriminant validity was demonstrated by mean group differences in some or all of the DI dimensions according to age and years in the United States.

Gender differences in psychological distress among immigrants from the former Soviet Union

In this study we compared rates and correlates of psychological distress among immigrant women and men from the former Soviet Union. A demographic, migration, and social network questionnaire and the Symptom Checklist-90-R were administered to 935 female and 706 male immigrants. Older age and less time in the United States predicted distress in both gender groups. However, having less education, leaving relatives behind, and not being sponsored by friends or a religious organization predicted greater distress for women. Women reported significantly more distress than men except for those men who were married and retired.

Condom Beliefs in Urban, Low Income, African American and Hispanic Youth

This article focuses on the condom beliefs of low income, urban African American and Hispanic youth living in the Midwest. The condom beliefs under investigation were derived from prior research with members of this population and through consultation with African American and Hispanic youth and service providers. Significant gender, ethnic, and acculturation differences were found among beliefs related to frequency of condom use in the past year (p < .05). These differences indicated that women, African American respondents, and Hispanic respondents high in acculturation tended to have more neutral or more positive views about condoms than other types of respondents.

To transform or not transform skewed data for psychometric analysis that is the question

BackgroundAlthough data transformation is generally recommended, its benefits of have not been widely studied. This report reviews evidence regarding the costs and benefits of transforming skewed data with respect to two statistics commonly used in psychometric analyses: the Cronbach alpha and the Pearson product-moment correlation. MethodsData describing 758 immigrants from the former Soviet Union who completed a Russian language version of the Symptom Checklist-90-Revised (SCL-90-R) were used to demonstrate the effects of transformation. More than half (55%) of the SCL-90-R items had a problematic skew. The Cronbach alpha and the Pearson product-moment correlation were calculated for original item responses as well as for square root and log transformations of these responses. Sample size (full, 30%, 20%), transformation type (square root or log transformation), and transformation method (sum items first and then transform, transform items first and then sum) were manipulated to evaluate the relevance of these factors to transformation. ResultsRegardless of sample size, neither the Cronbach alpha nor the Pearson product-moment correlation showed a difference between original and transformed data, with one exception. When items were transformed first before being summed in the calculation of the Pearson product-moment correlation, inconsistently higher (+.05) or slightly lower values (−.01) were observed relative to those created with the nontransformed data across the different sample sizes. ConclusionsThese findings suggest that data transformation is not always needed or advisable when the Cronbach alpha or Pearson product-moment correlation is calculated for instruments with skewed item responses.

Sexual networks of African-American and Hispanic youth

Background and Objectives: To describe the characteristics of several types of sexual partners of African‐American and Hispanic urban youth and to determine the association of these characteristics with condom use, contraceptive use, experience with sexually transmitted diseases, and sexual practices. Study Design: Data were drawn from personal interviews with a probability sample of low‐income urban youth, age 15 to 24 years, conducted in Detroit in 1991 (N = 1,435). Results: Although both ethnic groups tended to form partnerships most often within their own group, Hispanics had sexual partners who varied by ethnicity much more than did African Americans. Furthermore, the longer‐term relationships, those that resulted in marriage or cohabitation, were more likely to be with Hispanic partners than were other relationships. Hispanic men were also more likely to report white partners than were Hispanic women. In contrast, for African‐American men and women, most reported relationships were with other African Americans. Regardless of ethnicity or relationship type, women had older partners than did men. Partner differences in age or ethnicity showed few or no differences in condom use, reports of sexually transmitted diseases, oral intercourse, or use of contraceptive methods. Conclusions: Although relationships with people of similar age and ethnicity are common, bridges exist for transmission of sexually transmitted infection between different age and ethnic groups.