Gary F. Koeske

Acculturation, Stress, and Depressive Symptoms Among Korean Immigrants in the United States

Abstract A sample of 157 Korean immigrants responded to measures of acculturation level, stress from acculturation, and depressive symptoms. The authors hypothesized that adaptive acculturation would depend on assimilation regarding social interactions and the host cultures language as well as on retention of a core identity, including values and traditions of the culture of origin. Consistent with the mediation hypothesis, acculturation, based on a factor representing language use and social relationships, was related to lower acculturative stress and, in turn, lower depression. However, there was no direct support for the integrative, or bicultural, strategy of acculturation. Stress did not mediate the effect of a 2nd acculturation factor, identity and tradition-based acculturation. Rather, this measure of acculturation was directly related to higher depression (i.e., immigrants reporting abandonment of Korean identity, traditions, and values scored higher for depression).

Mental Health Treatment Seeking Among Older Adults with Depression: The Impact of Stigma and Race

OBJECTIVE Stigma associated with mental illness continues to be a significant barrier to help seeking, leading to negative attitudes about mental health treatment and deterring individuals who need services from seeking care. This study examined the impact of public stigma (negative attitudes held by the public) and internalized stigma (negative attitudes held by stigmatized individuals about themselves) on racial differences in treatment-seeking attitudes and behaviors among older adults with depression. METHOD Random digit dialing was utilized to identify a representative sample of 248 African American and white older adults (older than 60 years) with depression (symptoms assessed by the Patient Health Questionnaire-9). Telephone-based surveys were conducted to assess their treatment-seeking attitudes and behaviors and the factors that impacted these behaviors. RESULTS Depressed older adult participants endorsed a high level of public stigma and were not likely to be currently engaged in or did they intend to seek mental health treatment. Results also suggested that African American older adults were more likely to internalize stigma and endorsed less positive attitudes toward seeking mental health treatment than their white counterparts. Multiple regression analysis indicated that internalized stigma partially mediated the relationship between race and attitudes toward treatment. CONCLUSION Stigma associated with having a mental illness has a negative influence on attitudes and intentions toward seeking mental health services among older adults with depression, particularly African American elders. Interventions to target internalized stigma are needed to help engage this population in psychosocial mental health treatments.

Construct Validity of the Maslach Burnout Inventory: A Critical Review and Reconceptualization:

This article presents an evaluation of the construct validity of the Maslach Burnout Inventory (MBI). The authors base this critique on previously published findings and data collected through five studies carried out during an eight-year period, for which 328 social workers acted as respondents. Factor analyses and correlational studies designed to test predictions provided fairly consistent evidence for the utility of the MBI subscale measures of emotional exhaustion, personal accomplishment, and depersonalization. Additional analyses supported a reconceptualization of burnout and the MBI, one that regards exhaustion as the essence of burnout and treats accomplishment and depersonalization as related variables, but not as elements of burnout.

Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults

Objective: Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services. Method: A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data. Results: Thematic analysis of the interviews with African-American older adults is presented within three areas: (1) Beliefs about Depression Among Older African-Americans; (2) Barriers to Seeking Treatment for Older African-Americans; and (3) Cultural Coping Strategies for Depressed African-American Older Adults. Conclusion: Older African-Americans in this study identified a number of experiences living in the Black community that impacted their treatment seeking attitudes and behaviors, which led to identification and utilization of more culturally endorsed coping strategies to deal with their depression. Findings from this study provide a greater understanding of the stigma associated with having a mental illness and its influence on attitudes toward mental health services.

RESEARCH: A Preliminary Construct Validation of the Multidimensional Measurement of Religiousness/Spirituality Instrument: A Study of Southern USA Samples

The Multidimensional Measurement of Religiousness/Spirituality (MMRS) survey was administered to 515 respondents from the southeastern United States, 355 graduate and undergraduate students in Social Work, and 160 clients undergoing alcoholism or drug treatment. Exploratory factor analysis and reliability analyses resulted in retaining 59 of 81 MMRS items measuring 3 primary factors (Meaning, Spirituality, Religious Practices and Organized Religiousness) and 2 secondary factors (Guilt vs. Gods Grace, and Loving/Forgiving God). The primary factors were highly internally consistent and showed acceptable stability reliability for a subsample of clients; they also largely replicated intended dimensions of the MMRS. Convergent, discriminant, and theoretical construct validity were generally supported for the factors in correlational analyses, but the Guilt dimension, in particular, should be reevaluated in future research. Various limitations were discussed. It was suggested that the 3 primary factors could be reliably assessed with 10 items, and that this 30-item scale could be a very useful multidimensional research tool.

Racial differences in attitudes toward professional mental health treatment: the mediating effect of stigma.

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.

Student “burnout” as a mediator of the stress-outcome relationship

One hundred thirty-six graduate social work students participated in a questionnaire study designed to test the mediating influence of student burnout (strain) in the impact of student-specific stress on negative consequences. Consistent with the proposed stress→strain (burnout)→outcome model, burnout was significantly related to each of three stress indicators and to two outcome measures (intention to quit school and physical and psychological symptoms). In five of six tests, thedirect stress-to-outcome relationship was small and nonsignificant, consistent with the crucial mediating role of burnout. Contrary to previous model tests involving parenting, work, and student stress, there was only very limited evidence for a buffering influence of social support. Implications were drawn for stress theory and for policy focusing on assessment of student burnout and benefits arising from its alleviation.

Underestimation of Social Support Buffering

Most theory and practice in the helping professions assumes that informal social support acts as a buffer against stress, reducing its negative consequences on the stressed individual Despite many social psychological studies, the validity of this assumption has been difficult to establish empirically. This article argues that skepticism regarding the genuineness and importance of this hypothesized support buffering interaction is misplaced. This skepticism has been answered by well-designed and analyzed research. The article offers an analysis of why the significance of this buffering interaction may have been underestimated in earlier research, including hypotheses concerning the effect of stress severity on buffering.

Child and Mother Client Satisfaction Questionnaire Scores regarding Mental Health Services: Race, Age, and Gender Correlates.

This study used the Client Satisfaction Questionnaire (CSQ-8) to examine the level of consumer satisfaction with children’s (ages 8 to 17 years) outpatient mental health services. Analyses were completed using both individual satisfaction items and a summed scale score. The CSQ scale had satisfactory internal consistency reliability for both mothers (alpha = .96) and children (alpha = .93). Parents’ratings of satisfaction with their child’s treatment were not uniformly consistent with those of the child who was in treatment. Mothers’and children’s ratings were significantly, but only moderately, related. We also found that a child’s satisfaction with outpatient services, relative to that of the parent, may depend on the child’s gender, race, and age. These findings suggest that children’s satisfaction with mental health treatment was complexly determined and should not be inferred from their mothers’degree of satisfaction.

Working and Non-Working Students: Roles, Support and Well-Being

Abstract A questionnaire containing measures of physical and psychological symptoms and social support was completed by 142 MSW students. Students were grouped into three categories: Full-time students with no job, full-time students with part-time jobs, and part-time students with full-time jobs. Full-time students with part-time jobs reported more symptoms than full-time students with no jobs, a finding interpreted as consistent with a demands/resources analysis of stress. The latter group did not differ from part-time students with full-time jobs, despite the difference in number of roles held. Analysis controlling for associated variables indicated that it was the specific combination of full-time student and part-time work, not the total number of roles occupied, that was associated with higher distress. Evidence for a “buffering” effect of social support was found only for this high distress group. Results are discussed in terms of recent formulations concerning stress and multiple role occupancy, a...