Rick A. Cruz

Alcohol use severity and depressive symptoms among late adolescent Hispanics: testing associations of acculturation and enculturation in a bicultural transaction model

Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes.

Cultural dynamics and marital relationship quality in Mexican-origin families.

Prior research suggests that acculturation may influence relationship outcomes among Mexican-origin married couples, including marital adjustment and distress. Despite much theory and research on parent-child cultural differences and disruptions in the parent-child relationship, no previous research has investigated possible associations between husband-wife cultural differences and marital relationship quality. With a sample of Mexican-origin married couples (N = 398), the current study investigated the relations between husband-wife differences in acculturation (American orientation) and enculturation (Mexican orientation) with husband and wife reports of positive marital qualities (warmth and relationship satisfaction). To clarify and extend previous research, the current study also investigated within-person models of cultural orientation domains as related to positive marital quality. Results provide partial evidence showing that dyadic cultural differences are associated with lower positive marital quality while cultural similarity is associated with higher positive marital quality; however, the relations are complex and suggest that the associations between wife cultural orientation and positive marital quality may depend on husband cultural orientation (and vice versa). Findings also implicate the importance of assessing spouse bidimensional cultural orientation by showing that the relation between spouse acculturation level and relationship quality may depend on his or her enculturation level. Additional nuances in the findings illustrate the importance of assessing multiple domains of cultural orientation, including language use and cultural values. We highlight several future directions for research investigating nuances in spouse cultural dynamics and relationship processes.

Evaluating an adjunctive mobile app to enhance psychological flexibility in acceptance and commitment therapy

The primary aims of this study were to evaluate the feasibility and potential efficacy of a novel adjunctive mobile app designed to enhance the acquisition, strengthening, and generalization of acceptance and commitment therapy (ACT) skills being taught in therapy. A sample of 14 depressed/anxious clients receiving ACT used the ACT Daily app for 2 weeks in a pre–post, open trial design. Participants reported a high degree of program satisfaction. Clients significantly improved over the 2-week period on depression and anxiety symptoms as well as a range of psychological inflexibility measures. Analyses of mobile app data indicated effects of ACT Daily skill coaching on in-the-moment measures of inflexibility and symptoms, with unique effects found for acceptance and mindfulness. Adjunctive ACT mobile apps appear promising in enhancing therapy effects on psychological inflexibility and outcomes. A tailored skill coaching approach like ACT Daily based on randomly prompted assessments may be especially promising.

Mexican-Origin Youth Substance Use Trajectories: Associations with Cultural and Family Factors.

The current study identified alcohol and cannabis use trajectories among a sample of Mexican-origin youth and examined cultural and familial correlates from childhood to adolescence. Mexican-origin youth (N = 674) from Northern California were assessed annually from ages 10 to 17 (8 waves). Latent class growth modeling examined variability in developmental trajectories for last 3-month alcohol and cannabis use frequency. Analyses also examined between-trajectory differences in youth’s cultural practices and values, family cultural conflict, general parent–child conflict, and parental monitoring at 4 time points from ages 10 to 16. Analyses resulted in a 4-class model for alcohol use, comprising nonusers (62%), early-increasing (10%), adolescent-limited (11%), and late-onset (17%) subgroups, and a 4-class model for cannabis use, including nonusers (74%), early-increasing (8%), occasional use (16%), and high-declining (2%) subgroups. Findings suggested that early language use (higher English at age 10 and lower Spanish at age 12) was a temporally distal marker for several alcohol and cannabis use trajectories, whereas lower traditional family values at ages 14 and 16 were associated with several classes characterized by early substance use. Elevations in familial (parent–child conflict, parental monitoring) risk factors co-occurred in time and generally suggested temporally proximal connections with substance use behavior. Further, there was evidence that a less prominent decline in certain protective factors (e.g., father monitoring) was associated with reductions in substance use. These findings inform the literature by describing youth subgroups with variable risk for substance use development, and suggest modifiable risk factors associated with more frequent substance use trajectories.

Specific PTSD symptom clusters mediate the association of military sexual trauma severity and sexual function and satisfaction in female service members/veterans

BACKGROUND Sexual satisfaction and function are vastly understudied in female service members/veterans (SM/Vs). Military sexual trauma (MST) is associated with poorer sexual satisfaction and function, but the mechanism through which MST relates to sexual satisfaction and function is unknown. Posttraumatic stress disorder (PTSD) is one of the most frequent diagnoses following MST, and those with poorer sexual satisfaction and function experience higher PTSD symptoms, particularly numbing and anhedonia symptom clusters. In this study, we examined which symptom clusters (re-experiencing, avoidance, negative alterations in cognition and mood [NACM], anhedonia, dysphoric and anxious arousal) mediated the relationship between MST and sexual satisfaction and function. METHOD Female SM/Vs (N = 1,189) completed self-report measures of MST severity (none, harassment only, assault), PTSD, sexual satisfaction, and sexual function, as well as a demographic inventory. RESULTS Anhedonia and dysphoric arousal fully mediated the association between assault MST and sexual satisfaction and function. NACM fully mediated the association between harassment and assault MST and sexual satisfaction. Finally, dysphoric arousal significantly mediated the association of harassment MST with sexual satisfaction and function. LIMITATIONS Data was cross-sectional and based on self-report. CONCLUSIONS The relationship between MST and sexual satisfaction and function may be mediated through specific PTSD symptom clusters. As there are no evidenced-based treatments to improve sexual satisfaction and function in female SM/Vs, additional research is needed to develop and pilot interventions. Among those with a history of MST, targeting NACM, anhedonia, and dysphoric arousal may be most effective in addressing sexual concerns.

Comparing in-the-moment skill coaching effects from tailored versus non-tailored acceptance and commitment therapy mobile apps in a non-clinical sample

ABSTRACT Mobile apps are promising for teaching how to practice psychological skills in high-risk and in vivo momentary situations, but there has been minimal research on the immediate effects of app-based skill coaching on mental health in-the-moment. This study analyzed the mobile app data in a non-clinical sample of 39 adults participating in a larger randomized controlled trial, with participants randomized to an acceptance and commitment therapy (ACT) mobile app that tailors skill coaching based on in-the-moment variables (n = 17) or an app that provides randomly selected skill coaching (n = 22). Data were collected before and after each ACT skill coaching session on proximal outcome (depression, anxiety, and engagement in meaningful activity) and ACT process variables. Multilevel models indicated significant immediate improvements on average following ACT skill coaching sessions on all proximal outcome and ACT process variables, although with relatively small effects ranging between 0.17 and 0.27 SD units change. Larger immediate pre-to-post effects from ACT coaching sessions were found for anxiety, experiential avoidance, and cognitive fusion in the tailored app versus random app condition. Overall, results suggest that an ACT app can have immediate, in-the-moment effects on psychological functioning, which may be enhanced by tailoring skills to current context.

Cultural Orientation Trajectories and Substance Use: Findings From a Longitudinal Study of Mexican-Origin Youth

Cultural adaptation may influence Latino youth substance use (SU) development, yet few longitudinal studies have examined cultural change over time and adolescent SU outcomes. Using longitudinal data collected annually across ages 10-16 from 674 Mexican-origin youth (50% female), the authors characterized cultural adaptation patterns for language use (English and Spanish use), values (American values and familism values), and identity (ethnic pride), and examined whether these cultural adaptation patterns were associated with differential SU risk. Youth with increasing bilingualism and high/stable family values had lower SU risk compared to youth who primarily spoke English and endorsed decreasing family values, respectively. Ethnic pride trajectories were not associated with SU. Findings highlight the importance of considering cultural change related to Latino youth SU.