Catherine Ramsay Roberts

The Structure of Ethnic Identity of Young Adolescents from Diverse Ethnocultural Groups

The purpose for this study was to examine the structure and construct validity of a measure of ethnic identity among young adolescents from diverse ethnic groups. Students in sixth, seventh, and eighth grades (N = 5,423) from diverse ethnic groups completed the Multigroup Ethnic Identity Measure (MEIM), measures of psychological well-being and a measure of salience of ethnicity. Factor analyses of data for the three largest ethnic groups (European American, African American, Mexican American) yielded a two-factor structure that corresponded to two theoretical approaches to ethnic identity, as hypothesized. Similar patterns in magnitude of loadings were observed across groups, indicating that the MEIM could be used as a global composite index of ethnic identity. Ethnic identity was related positively to measures of psychological well-being such as coping ability, mastery, self-esteem and optimism, and negatively to measures of loneliness and depression. MEIM scores also were moderately strong and positive with salience (the importance of a person’s own ethnic background in his or her life), across ethnic groups.

Ethnocultural Differences in Prevalence of Adolescent Depression

Data from an ethnically diverse sample of middle school (Grades 6–8) students (n = 5,423) are analyzed for ethnic differences in major depression. The point prevalence of major depression was 8.4% without and 4.3% with impairment. Data were sufficient to calculate prevalences for nine ethnic groups. Prevalences adjusted for impairment ranged from 1.9% for youths of Chinese descent to 6.6% for those of Mexican decent. African and Mexican American youths had significantly higher crude rates of depression without impairment, but only the latter had significantly higher rates of depression with impairment. Multivariate (logistic regression) analyses, adjusting for the effects of age, gender, and socioeconomic status (SES), yielded significant odds ratios for only one group. Mexican American youths were at elevated risk for both depression without (OR = 1.74, p < .05) and depression with impairment (OR = 1.71, p < .05). There was no significant interaction of ethnicity and SES in relation to depression. Females had higher prevalences of depression with and without impairment, as did youths who reported that their SES was somewhat or much worse off than their peers. The data add to growing evidence that Mexican American youths are at increased risk of depression, and that community intervention efforts should specifically target this high-risk group.

Chronic Insomnia and Its Negative Consequences for Health and Functioning of Adolescents : A 12-Month Prospective Study

PURPOSE To estimate prevalence and chronicity of insomnia and the impact of chronic insomnia on health and functioning of adolescents. METHODS Data were collected from 4175 youths 11-17 at baseline and 3134 a year later sampled from managed care groups in a large metropolitan area. Insomnia was assessed by youth-reported DSM-IV symptom criteria. Outcomes are three measures of somatic health, three measures of mental health, two measures of substance use, three measures of interpersonal problems, and three of daily activities. RESULTS Over one-fourth reported one or more symptoms of insomnia at baseline and about 5% met diagnostic criteria for insomnia. Almost 46% of those who reported one or more symptoms of insomnia in Wave 1 continued to be cases at Wave 2 and 24% met DSM-IV symptom criteria for chronic insomnia (cases in Wave 1 were also cases in Wave 2). Multivariate analyses found chronic insomnia increased subsequent risk for somatic health problems, interpersonal problems, psychological problems, and daily activities. Significant odds (p < .05) ranged from 1.6 to 5.6 for poor outcomes. These results are the first reported on chronic insomnia among youths, and corroborate, using prospective data, previous findings on correlates of disturbed sleep based on cross-sectional studies. CONCLUSIONS Insomnia is both common and chronic among adolescents. The data indicate that the burden of insomnia is comparable to that of other psychiatric disorders such as mood, anxiety, disruptive, and substance use disorders. Chronic insomnia severely impacts future health and functioning of youths. Those with chronic insomnia are more likely to seek medical care. These data suggest primary care settings might provide a venue for screening and early intervention for adolescent insomnia.

SLEEPLESS IN ADOLESCENCE: PROSPECTIVE DATA ON SLEEP DEPRIVATION, HEALTH AND FUNCTIONING

We estimate prevalence, incidence and persistence of short sleep or sleep deprivation in a two wave cohort study of 4175 youths 11-17 years old at baseline and 3134 of these a year later. Data were collected using computer interviews and questionnaires. Sleep deprivation was defined as 6h or less per night during the past 4 weeks. Weighted logistic regression procedures were employed to calculate prevalence, incidence, persistence/chronicity, and odds ratios. Prevalence rates and rates of persistence suggest sleep deprivation is highly prevalent and chronic. Multivariate analyses indicate that short sleep increases risk across multiple domains of dysfunction, suggesting pervasive deleterious effects. The broad impact of sleep deprivation and its pervasiveness suggests interventions will need to focus on multilevel changes to increase sleep time and reduce the negative impact of sleep deprivation among adolescents.

Functioning of Adolescents With Symptoms of Disturbed Sleep

The objective of the study was to examine the association between disturbed sleep and the functioning of adolescents, in particular cumulative effects on functioning across multiple life domains. Data from a large, school-based survey (n = 5,423) were used to examine the association between eight indicators of psychological, interpersonal, and somatic functioning and symptoms of insomnia and hypersomnia among adolescents. The strongest correlates of insomnia were disturbed mood (OR = 5.9), fatigue (OR = 7.4), and suicidal ideation (OR = 3.4). The same pattern held for hypersomnia, although the associations were not as strong for fatigue (OR = 6.8), mood disturbance (OR = 3.5), and suicide ideation (OR = 2.8). Youths who experienced both insomnia and hypersomnia had greater odds of psychological, interpersonal, and somatic dysfunction than youths who had experienced only one sleep disturbance. Cumulative effects of sleep problems were pronounced, with 27.6% of those with hypersomnia, 41.7% of those with insomnia, and 59.2% of those with both sleep problems reporting three or more types of dysfunction. The results suggest that adolescents experiencing disturbed sleep also experience a range of deficits in functioning. Further, youths with disturbed sleep are more likely to manifest multiple deficits in functioning. From the available evidence, however, it is not possible to specify what the causal pathways are. What are needed are cohort studies designed to examine the association of disturbed sleep and functional impairment among adolescents prospectively.

Suicidal Thinking Among Adolescents With a History of Attempted Suicide

OBJECTIVE To examine the risk of suicidal plans and ideation, depression, and other factors (low self-esteem, loneliness, fatalism, pessimism) among adolescents with a lifetime history of attempted suicide. METHOD A self-administered questionnaire was used in a school-based survey of five middle schools (grades 6 through 8) enrolling 6,400 students. Usable questionnaires were obtained from 5,423 (85.3%). Data were obtained on a wide range of constructs including recent and lifetime suicide attempts, recent and lifetime suicide plans, recent ideation, symptoms of DSM-IV major depression, self-esteem, pessimism, loneliness, and fatalism. RESULTS Data on crude prevalence showed thoughts about death, wishing to be dead, thoughts of suicide, and suicide plans were all significantly higher among youths with a history of attempts. Suicidal thinking was related to being more lonely, more fatalistic, and more pessimistic, and to less self-esteem, in addition to depression and a history of attempts. Multivariate analyses revealed the strongest factors associated with current suicidal thinking were history of attempts (odds ratio [OR] = 3.50), depression (OR = 5.34), and recent life stress (OR = 2.64). Compared with youths with none of the factors examined, those with six or more were at extreme risk (OR = 67.87). CONCLUSIONS The strong association between history of suicide attempts, current ideation, and depression indicates that past suicide attempts occur in the context of other signs of psychosocial dysfunction. Given the paucity of epidemiological data on the natural history of suicidal behaviors among youths, more epidemiological studies of the antecedents and consequences of the range of suicidal behaviors among children and adolescents are needed. Given the high risk of subsequent suicidal behaviors by youths who have attempted but not completed suicide, this constitutes a high-risk population on which future research should focus.

Japan-U.S. comparison of responses to depression scale items among adult workers

The operating characteristics of the Center for Epidemiologic Studies Depression Scale were compared between Japanese and U.S. adult workers. Data were analyzed from age- and education-matched male white collar workers (n = 368 for each) selected from 2016 workers in Japan and 3059 in the United States. The U.S. data were obtained from the 1974-75 Augmentation Survey of the National Health and Examination Survey I. The Japanese responses to positively worded items markedly differed from those of U.S. workers, whereas responses to negatively worded items were generally comparable in the two groups. Thus, spuriously higher positive subscale and whole scale scores were found among the Japanese workers compared with U.S. workers (mean scores: 6.03 vs. 1.83 for the positive subscale and 9.94 vs. 5.35 for the whole scale, respectively; both differences were statistically significant). Negative subscale scores did not differ significantly in the two samples (3.91 vs. 3.52). The present study confirmed the hypothesis of Iwata et al. that Japanese respondents have a tendency to suppress the expression of positive affect.

Ethnocultural differences in sleep complaints among adolescents.

Data from a school survey (N = 5423) were used to examine differences in sleep complaints among adolescents from nine ethnocultural groups. Compared with Anglo youths, Chinese American youths were at significantly lower risk for insomnia, whereas Mexican American youths had an elevated risk, adjusting for the effects of age, gender, and socioeconomic status. Adjusting for the same three covariates, African, Mexican and Central American youths were at elevated risk for hypersomnia. No group was at lower risk for hypersomnia than the Anglos. The results suggest minority status may affect risk for sleep problems but that the direction and the magnitude of the effects vary depending on the outcome examined, severity of the problem, and the ethnic group studied. Given the paucity of data on culture and risk for disturbed sleep among adolescents, more research is needed on the role of ethnocultural background on sleep.

Mental health problems of adolescents as reported by their caregivers: a comparison of European, African, and Latino Americans.

This article examines problem recognition across ethnic groups by focusing on parental reports of mental health problems in adolescents. Data were collected from 1 youth (aged 11–17) and 1 caregiver from a community-based sample of households in the Houston metropolitan area. The sample was 4175 youths and their caregivers (37.8% European, 35.00% African, 25.4% Latino, and 1.8% other American). Indicators of mental health were perceived mental health, life dissatisfaction, and whether adolescents had a mental health problem in the past year. European Americans were more likely to rate the mental health of adolescents as fair or poor, were about twice as likely to report that adolescents were dissatisfied with their lives, and that adolescents had a mental health problem in the past year. Interventions to help minority families in the identification of youths mental health problems may need to address cultural differences in the definition of mental health problems or in the benefit of labeling mental health problems that may serve as barriers to help-seeking.

One-year incidence of psychiatric disorders and associated risk factors among adolescents in the community

BACKGROUND We have few data on incidence of psychiatric disorders among adolescents. This study examined first incidence of disorders among adolescents and baseline factors which increased or decreased risk of new onset cases a year later. METHODS Data were analyzed from Teen Health 2000 (TH2K), a probability sample of 4,175 youths 11-17 and their parents assessed at baseline and 3,134 of these youth-parent dyads followed up a year later. Disorders examined were anxiety, mood, attention deficit hyperactivity disorder (ADHD), disruptive, and substance abuse/dependence disorders in the past year. Risk and protective factors were assessed from three domains: status factors, personal and social resources, and stressors. Logistic regression models were used to estimate odds of incident disorders for each risk and protective factor. RESULTS Incidence rates were 2.8% for anxiety, 1.5% for mood, 1.2% for ADHD, 2.5% for disruptive, 2.9% for substance abuse/dependence, and 7.5% for one or more DSM-IV disorders. Multivariate analyses identified few independent predictors of incidence. The most consistent factors across disorders involved indicators of stress. The role of adverse family context was particularly noteworthy, predicting incidence of every disorder examined. Personal resources such as mastery consistently enhanced resilience to onset of first episodes. The presence of multiple risk factors, cumulative burden, substantially increased risk of first incidence of all disorders examined. CONCLUSIONS The incidence of any disorder of 7.5% was similar to two earlier studies using DSM-III-R criteria (8.9 and 10.6, respectively). This is the first study to estimate incidence of DSM-IV disorders for a range of diagnostic categories, and with the exception of substance use disorders, the rates are quite different from one earlier study using DSM-II-R criteria. A clear pattern emerged from the analyses. That is, psychiatric disorders, like other chronic diseases, are the product of multiple factors and these factors in turn have effects on multiple disorders.