Nancy Howells Wrobel

Acculturative Stress and Depression in an Elderly Arabic Sample

Acculturative stress and relevant demographic variables, including immigration status, English skills, level of education, age, gender, country of origin, and years since immigration to the U. S. are examined along with their relationship to depressive symptoms. The 200 Arab-American and recent Arab immigrant participants ranged from age 60–92 and represented eight countries of origin. Most had limited fluency in English. Arabic versions of the Multi-dimensional Acculturative Stress Inventory (MASI) and Geriatric Depression Scale were administered. MASI and GDS results indicated greater degrees of acculturative stress and depression for those with a refugee or temporary resident status. More recent entry into the U.S. also predicted greater stress, while greater levels of education and English skills predicted lower levels of stress and depression. Composite stress levels and the nature of stress varied by country of origin. Although demographic variables were predictive of depression when examined separately, multiple regression analyses revealed that perceived acculturative stress, particularly pressure to learn English, provided a notable increment in prediction of depression over the demographic variables.

Validity of self- and parent-report scales in screening students for behavioral and emotional problems in elementary school

The comparative validity of the child-report Classroom Screening Scale (CLASS) from the Personality Inventory for Youth (PIY), and the parent-report Adjustment Scale (ADJ) from the Personality Inventory for Children (PIC) was examined. The subjects were 111 children from fourth- through sixth-grade regular education classrooms. Children were classified as positive or negative for risk status on each screening scale using a cutoff of 60T. Parent description identified a higher proportion of children as at risk. Those identified as “at risk” by either parent or child report were more likely than others to have clinically elevated scores on both the PIC and PIY clinical scales. High scores on CLASS were more likely to have clinically significant elevations than were high scorers on ADJ. Parent report appeared to be sensitive to overt behavioral problems, while self-report was sensitive to mood disturbances and withdrawal.

Arab Refugees: Trauma, Resilience, and Recovery

This chapter provides a brief introduction to the history of Arab refugees in the USA, an analysis of the traumatic stressors that different gender and age groups encounter pre- and post-refuge, and the effects of these stressors on their well-being. Further, it explores the resilience and protective factors of Arab refugees. Resilience and protective factors are used in this chapter to indicate internal and external factors that the evidence shows are associated with “good” outcome in spite of adversities (e.g., Luthar et al., Child Development 71(3):543–562, 2000). The development-based traumatology framework that highlights the etiology of refugees’ cumulative trauma is discussed (Kira, Traumatology 16(4):128–141, 2010). Also, two models of therapeutic interventions for Arab refugees are introduced: individual therapy that includes the transdiagnostic and complex trauma approaches that are mostly uni-systemic, and the ecological multi-systemic approaches. Finally, community outreach and advocacy are discussed as part of the recommended ecological model of recovery.

Performance of the Personality Inventory for Youth Validity Scales

Response sets as well as cognitive and academic deficits compromise the validity of child and adolescent self-report of emotional adjustment. Three studies using clinical and asymptomatic samples of 4th to 12th grade students detail applications of the four validity scales of the Personality Inventory for Youth (PIY), namely, (a) Validity (VAL) a scale of six highly improbable statements, (b) Inconsistency (INC) consisting of pairs of highly correlated statements, (c) Dissimulation (FB) constructed of statements that were infrequent and characteristic of intentional distortion, and (d) Defensiveness (DEF) an extension of the Lie scale of the parent-report Personality Inventory for Children. The effects of minimizing, malingering, and random response sets on the PLY validity scales are reported. The importance of such validity scales derived from child and adolescent response is discussed.

Racial Differences in Adolescent Self-Report: A Comparative Validity Study Using Homogeneous MMPI Content Measures.

Minnesota Multiphasic Personality Inventories (MMPIs) were administered to an urban-mixed-race sample of adolescent psychiatric inpatients and outpatients (N = 218). Racial differences were noted on 4 of the 13 raw Wiggins scale scores, with scores for African-American patients more elevated on Poor Health, Feminine Interests, Phobias, and Psychoticism. A backward multiple-regression procedure was used to predict raw Wiggins scale scores from parent descriptions as measured by the Personality Inventory for Children clinical scales. Predictors supported the validity of the Organic Symptoms, Social Maladjustment, Family Problems, Authority Conflict, and Hypomania scales, and to some extent, Poor Morale, Depression, Poor Health, and Phobias. Predictors differed across racial groups for 9 of the scales, with particular discrepancies in predictive meaning for Poor Health, Hypomania, Family Problems, and Authority Conflict. Implications for MMPI-A content scales are discussed.

Refining Adolescent MMPI Interpretations: Moderating Effects of Gender in Prediction of Descriptions from Parents.

The present study investigated external correlates of Minnesota Multiphasic Personality Inventory (MMPI) profile scales in a racially mixed urban sample of 247 adolescent psychiatric inpatients and outpatients. The correlates included consensually nominated items from the Personality Inventory for Children (PIC) completed by the patients mother or surrogate mother. Correlates were calculated separately by sex. Validity and meaning of the adolescents MMPI profile relative to the PIC correlates were examined

Preliminary Validation of an Arabic Version of the MMSE in the Elderly

Abstract Validity of an Arabic version of the Mini-Mental State Exam (MMSE) is evaluated through prediction of scores on the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE) by item, subscale, and total scores. The MMSE was administered to 200 elderly Arab-Americans, and the IQCODE was completed by related informants. Multiple regression analyses indicated that both total MMSE and a combination of 3 MMSE subscales significantly predicted IQCODE, beyond effects of age or educational level. Analyses of the sensitivity and specificity of the MMSE in prediction of dichotomized IQCODE values across MMSE cut-off scores indicate that the utility of the MMSE varies across educational levels. MMSE items varied in their ability to demonstrate differing performance levels in individuals high and low in cognitive decline.

A Preliminary Report on the Validation of the Geriatric Depression Scale in Arabic

Abstract The validity of an Arabic translation of the Geriatric Depression Scale (GDS) is examined in this preliminary report. The GDS and Mini-Mental Status Exam (MMSE) were administered to 200 elderly Arab-Americans, and the GDS Collateral (GDSCOL) was completed by related informants. The prediction of GDS from GDSCOL scores was significant at the p < .01 level, with addition of the MMSE scores providing a slight increment in prediction. With reported prior diagnosis of depression as a criterion, the specificity of the scales is strong (GDS = .90, GDSCOL = .91), but the sensitivity appeared relatively low. Factors derived from the GDS paralleled those found in prior studies. Additional research is needed to evaluate concordance of the self-report GDS with psychiatrically determined diagnosis of depression.

Mental Health Risks in Arab Americans Across the Lifespan

The unique nature of mental health risks, as well as protective factors, in Arab Americans is explored from a developmental perspective. The timing of entry into the USA, relative to age and historical events is considered in terms of the impact on identity as well as the degree and nature of stress experienced. A complex relationship between acculturation and mental health is revealed. The most adaptive pattern of acculturation may depend upon an interaction of personal, cultural, and situational factors, including religious affiliation, education, and nature of relocation. Recent immigrants with high levels of pre-immigration trauma as well as perceived hostility are at risk for mental health problems such as depression, panic, and PTSD. Yet, perceived personal control over hostile environments may enhance resilience. Cultural elements, including an emphasis on shame may limit both help-seeking behaviors, and clinical research. Assessment and treatment practices within a cultural context are detailed.

Self-Report Problem Scales and Subscales and Behavioral Ratings Provided by Peers Unique Evidence of Test Validity

The relationship between children’s self-reported problems on the Personality Inventory for Youth (PIY) and peer descriptors derived from the Pupil Evaluation Inventory was examined in a regular education sample of 156 children in fourth through eighth grade. The relative contributions of the PIY scales and subscales to the prediction of peer ratings were compared. Peer ratings of withdrawn, disruptive, and prosocial behaviors were substantially correlated to self-report problem scales made up of logically related content. The addition of more content-specific PIY subscales contributed to the prediction made by PIY scales of peer-reported disruptive behaviors and withdrawal.