Les B. Whitbeck

Conceptualizing and Measuring Historical Trauma Among American Indian People

This article reports on the development of two measures relating to historical trauma among American Indian people: The Historical Loss Scale and The Historical Loss Associated Symptoms Scale. Measurement characteristics including frequencies, internal reliability, and confirmatory factor analyses were calculated based on 143 American Indian adult parents of children aged 10 through 12 years who are part of an ongoing longitudinal study of American Indian families in the upper Midwest. Results indicate both scales have high internal reliability. Frequencies indicate that the current generation of American Indian adults have frequent thoughts pertaining to historical losses and that they associate these losses with negative feelings. Two factors of the Historical Loss Associated Symptoms Scale indicate one anxiety/depression component and one anger/avoidance component. The results are discussed in terms of future research and theory pertaining to historical trauma among American Indian people.

Perceived discrimination and early substance abuse among American Indian children.

This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance abuse among 195 American Indian 5 through 8 graders from three reservations that share a common culture (e.g., language, spiritual beliefs, and traditional practices) in the upper Midwest. The findings indicated that, although perceived discrimination contributed significantly to internalizing symptoms among the adolescents, internalizing symptoms were unrelated to early substance abuse. Rather, the effects of perceived discrimination on early substance abuse were mediated by adolescent anger and delinquent behaviors. The results are discussed in terms of the consequences of perceived discrimination on the development of American Indian early adolescents.

Mental disorder, subsistence strategies, and victimization among gay, lesbian, and bisexual homeless and runaway adolescents

This study compares participation in deviant subsistence strategies, street victimization, and lifetime prevalence of five mental disorders (conduct disorder, major depressive disorder, post‐traumatic stress disorder, alcohol abuse, and drug abuse) among heterosexual males and females (n = 366) and gay, lesbian, and bisexual (n = 63) homeless and runaway adolescents from the first wave of a longitudinal study of homeless youth in four Midwestern states. The results indicate that gay, lesbian, and bisexual adolescents were more likely to have been physically and sexually abused by caretakers, were more likely to engage in risky survival strategies when on their own (including survival sex), were more likely to be physically and sexually victimized when on the streets, and were more likely to meet criteria for mental disorder than were their heterosexual counterparts.

Perceived Discrimination, Traditional Practices, and Depressive Symptoms among American Indians in the Upper Midwest*

American Indian adults are thought to experience significant depressive symptoms at rates several times higher than adults in the general population, yet we know very little about factors associated with depressive symptoms among this under studied group. Many researchers have argued that depressive symptoms are associated with conflicts between American Indian traditional cultural values, practices, and beliefs and those of the majority culture. This report, based on a sample 287 American Indian adults from the upper Midwest, takes into account two measures of cultural effects: perceived discrimination, as one indicator of culture conflict, and traditional practices, as a measure of cultural identification. The results indicate that discrimination is strongly associated with depressive symptoms among American Indian adults and that engaging in traditional practices is negatively related to depressive symptoms. Moreover, interaction effects between perceived discrimination and traditional practices indicate that engaging in traditional practices buffers the negative effects of discrimination among those who regularly participate in them.

Diagnostic prevalence rates from early to mid-adolescence among indigenous adolescents: first results from a longitudinal study.

OBJECTIVEnInvestigate change in prevalence rates for mental and substance abuse disorders between early and mid-adolescence among a cohort of indigenous adolescents.nnnMETHODnThe data are from a lagged, sequential study of 651 indigenous adolescents from a single culture in the northern Midwest United States and Canada. At waves 1 (ages 10-12 years) and 4 (ages 13-15 years), one adult caretaker and one tribally enrolled adolescent completed a computer-assisted personal interview that included Diagnostic Interview Schedule for Children-Revised assessment for 11 diagnoses. Multivariate analyses investigate effects of wave 1 adolescent diagnosis and wave 1 biological mother diagnosis (University of Michigan Composite International Diagnostic Interview) on wave 4 diagnostic outcomes.nnnRESULTSnThe findings show a increase in prevalence rates for substance abuse disorders and conduct disorders between ages 10 and 12 years and 13 and 15 years among indigenous adolescents, with these disorders affecting more than one fourth of the children. The rate of lifetime conduct disorder is about twice that expected in general population studies (23.4% versus 5%-10%), and the rate of lifetime substance abuse disorder (27.2%) is three times that reported in the 2004 National Survey on Drug Use and Health (9.4%) for individuals 12 years or older. Prevalence rates for any single mental or substance use disorder (44.8 lifetime) for the 13- to 15-year-olds are similar to the lifetime prevalence rates reported in the National Comorbidity Survey-Replication (46.4%) for individuals 18 years and older.nnnCONCLUSIONSnA mental health crisis exists on the indigenous reservations and reserves that participated in this study. Current service systems are overwhelmed and unable to meet the demands placed upon them.

Mental Health and Substance Abuse Services Preferences among American Indian People of the Northern Midwest

ABSTRACTThis study examines factors that influence preferences between traditional cultural and western mental health and substance use associated care among American Indians from the northern Midwest. Personal interviews were conducted with 865 parents/caretakers of tribally enrolled youth concerning their preferences for traditional/cultural and formal healthcare for mental health or substance abuse problems. Adults strongly preferred traditional informal services to formal medical services. In addition, formal services on reservation were preferred to off reservation services. To better serve the mental health and substance abuse treatment needs of American Indians, traditional informal services should be incorporated into the current medical model.

Mental Disorders among Parents/Caretakers of American Indian Early Adolescents in the Northern Midwest

BackgroundThis study reports prevalence and comorbidty of five DSM-III-R diagnoses (alcohol abuse, alcohol dependence, drug abuse, major depressive episode, and generalized anxiety disorder) among American Indian and Canadian First Nations parents/caretakers of children aged 10–12xa0years from the Northern Midwest United States and Canada. Lifetime prevalence rates were compared to adults in the National Comorbidity Survey (NCS) and Southwest and Northern Plains cultures from the AI-SUPERPFP study.MethodNative interviewers used computer-assisted personal interviews to administer the University of Michigan Composite International Diagnostic Interview (UM-CIDI) to 861 tribally enrolled parents and caretakers (625 females; 236 males) of 741 tribally enrolled children aged 10–12xa0years. Fathers/male caretakers ranged in age from 21xa0years to 68xa0years with an average age of 41xa0years; mothers/female caretakers ranged in age from 17xa0years to 77xa0years with an average of 39xa0years.ResultsAbout three-fourths (74.6%) of the adults met lifetime criteria for one of the five disorders; approximately one-third (31.6%) met lifetime criteria for two or more of the five disorders. Prevalence of the substance use disorders was higher than those in the general population (NCS); prevalence of internalizing disorders (major depressive disorder and generalized anxiety disorder) was very similar to those in the general population. Prevalence rates for alcohol abuse among the Northern Midwest adults were higher than those reported for Southwest and Northern Plains Tribes, but rates of alcohol dependency were very similar across cultures.ConclusionsThe higher prevalence rates for some mental disorders found for the Northern Midwest are discussed in terms of potential method variance. The Northern Midwest results reflect unique patterns of psychiatric disorders in the ubiquity of substance abuse disorders and the co-occurrence of substance abuse disorders with internalizing disorders. Reducing lifetime occurrences of substance abuse disorders would have an enormous positive impact on the mental health of this population.

Distress among Indigenous North Americans Generalized and Culturally Relevant Stressors

Stress process and life-course models of mental distress emphasize sociocultural and historical processes that influence stress exposure and the impact of stress on mental health outcomes. Drawing from these theoretical orientations as well as concepts from the historical trauma literature, the authors examine the effects of culturally relevant and more generalized sources of stress on distress among North American Indigenous adults and test for the potential cumulative and interactive effects of stress on distress across the life course via self-reported early childhood and adult and contemporary stressors. Results of ordinary least squares regression analyses reveal positive, significant associations between general stressors and distress as well as culturally meaningful stressors and distress. In addition, the authors found evidence of the accumulating and interactive impact of stress on psychological distress.

Exploring the Relationships of Perceived Discrimination, Anger, and Aggression among North American Indigenous Adolescents

A growing body of research has documented associations between discrimination, anger, and delinquency, but the exact nature of these associations remains unclear. Specifically, do aggressive behaviors emerge over time as a consequence of perceived discrimination and anger? Or do adolescents who engage in aggressive behavior perceive that they are being discriminated against and become angry? We use autoregressive cross-lagged path analysis on a sample of 692 Indigenous adolescents (mean age = 12 years) from the Northern Midwest and Canada to answer these research questions. Results showed that the direction of effects went only one way; both perceived discrimination and anger were significantly associated with subsequent aggression. Moreover, early discrimination and anger each had indirect effects on aggressive behavior three years later, and anger partially mediated the association between discrimination and aggression. Perceived discrimination is but one of many strains related to unequal social position that these Indigenous youth experience, and it has important implications for the proliferation of disparities in later life.

Depressive symptoms, gender, and growth in cigarette smoking among indigenous adolescents.

This study reports findings from two-level growth curve modeling of cigarette smoking and depressive symptoms based on the first three waves of data from a longitudinal study of Indigenous adolescents and their parents/caretakers in the northern Midwest and Canada. The 743 adolescents were aged 10-13 years at Wave 1 and 12-15 years at Wave 3. Over the three years of the study the overall retention rate was 93%. By Wave 3, 39% of the adolescent girls and 25% of the boys had smoked cigarettes in the past 12 months. The growth curve results indicated that smoking increased for both adolescent boys and girls across time. Depressive symptoms were associated with an increase in cigarette smoking for girls but not boys.