Robert G. Malgady

Biculturality among Puerto Rican adults in the United States

Identified the concept of acculturation as a cornerstone of immigration research, while questioning assumptions about zero-sum cultural change in acculturation scales and in procedures assessing biculturality. Involvements in the host society culture and the culture of origin should be assessed separately in order to reflect the complexities of the cultural interactions immigrants and their offspring experience. To evaluate this prescription, we convened focus groups of Puerto Rican adults to discuss their cultural experiences in Puerto Rico and in the United States. Discussions were content analyzed to develop acculturation items. Factor analysis of the responses of 403 first- and second-generation adults yielded two general factors, involvement in American culture and involvement in Puerto Rican culture, which demonstrated modest reliability, relative independence, and moderate correlations with traditional acculturation scale validators. Results of the study challenge the assumption of mutual cultural exclusivity in acculturative change; enable the measurement of degree of biculturality; and provide future directions for the assessment of acculturation in domains other than language usage. The concept of acculturation is integrated with recent formulations in community psychology which advocate a deeper and more extensive commitment to studying the implications of cultural phenomena and greater focus on the growing cultural diversity in the United States.

Issues of validity in the diagnostic interview schedule

The Diagnostic Interview Schedule, the chief instrument in contemporary studies in psychiatric epidemiology, enhances the reliability of psychiatric diagnosis and enables lay interviewers to closely reproduce psychiatric interviews. However, despite frequent references in the literature to the validity of the Diagnostic Interview Schedule, most studies fundamentally represent variations of reliability paradigms to the neglect of criterion-related validity. Mistaken assertions of validity persist in the psychometric language used to describe the Diagnostic Interview Schedule. This article examines the basis for claims and counterclaims of validity in accordance with standard psychometric definition, and identifies sources of erroneous reasoning in attempts to infer validity from reliability. The article presents a general framework organizing the process of diagnostic validation and discusses strategies for research seeking to validate psychiatric diagnoses achieved through the Diagnostic Interview Schedule.

Symptom severity in bilingual Hispanics as a function of clinician ethnicity and language of interview

Research on bilingual patients is equivocal about how language influences clinical judgment in psychiatric interviews. In this study, 148 Hispanics with schizophrenia, depression, and anxiety disorders were interviewed in English, Spanish, or both. Hispanic clinicians rated symptoms more severe than did Anglo clinicians, and severity was rated highest in bilingual interviews, followed by Spanish, and lowest in English. Results have implications for Diagnostic and Statistical Manual of Mental Disorders (4th edition; American Psychiatric Association, 1994) cultural considerations.

Evaluation of mental health. Issues of memory in the diagnostic interview schedule

Research on the Diagnostic Interview Schedule, the chief instrument in contemporary studies in psychiatric epidemiology, has supported its utility in enabling lay interviewers to reproduce psychiatric interviews within an acceptable margin of error. Nonetheless, we propose that the Diagnostic Interview Schedule commits itself to dubious assumptions regarding the accuracy of human memory, shared by other history-taking efforts, by relying on retrospective reports of lifetime DSM-III symptoms and episodic dating of symptom spells. For more than a century, the fallibility of human memory has been the topic of intensive experimental and naturalistic study, a history which is relevant to the construction of instruments like the Diagnostic Interview Schedule. The continuing use of retrospective lifetime symptom reports suggests that this literature has been largely ignored in the development and administration of the Diagnostic Interview Schedule. Prospectively organized research is needed to disclose the limits of human memory for recent psychiatric events and the mediating conditions under which memory for such events can be accurately retrieved and improved.

The mental health relevance of idioms of distress. Anger and perceptions of injustice among New York Puerto Ricans.

Cultural sensitivity in mental health research is enhanced by examining the collective perceptions of members of ethnic groups about their own idiomatic expressions of distress. Such an examination was conducted with Puerto Ricans living in New York City, beginning with focus group discussions. Their prevailing idioms of distress, based upon themes of anger and injustice, were correlated widely with professionally developed measures of anxiety, depression, and somatization and with utilization of professional mental health care. By examining the relationship between idioms of distress, saliently volunteered by members of the ethnic ingroup, on the one hand, and professional care and assessments of mental health, on the other, we increase our culturally based understanding of mental health in the community

Alcohol and drug use, and depression among hispanic men in early adulthood

Community research and clinical practice have shown that alcohol and drug use and depression are interrelated. Among Hispanics, acculturation may play a role in these relationships. To investigate these relationships as well as alcohol-related problems, we interviewed 288 Puerto Rican, Dominican, and Colombian men in early adulthood. No significant differences emerged in the proportions of abstainers across the three groups. Colombians drank significantly more frequently and had more alcohol-related problems than Dominicans. Dominicans were at least risk for and least likely to have alcohol-related problems. Puerto Ricans were much more likely to use drugs than the other Hispanic men. Drug use was associated with an increased likelihood of heavy drinking which, in turn, increased the risk of drug use and depression. Acculturation decreased the risk of drug use. Results are discussed in terms of implications for community psychology research and interventions.

Depression, Acculturation, and Motivations for Alcohol Use among Young Colombian, Dominican, and Puerto Rican Men

Increasing numbers of young Hispanic men are being treated for alcohol abuse and its consequences. To provide culturally competent services, there must be an understanding of subcultural differences in the antecedents of alcohol abuse and drinking problems. The present study examined the impact of depression, acculturation, and motivations as antecedents for drinking and drinking-related problems among 288 Colombian, Dominican, and Puerto Rican men. Path analyses suggest that for all three groups, depression is associated with drinking for psychological motivational reasons. Psychological motivations, in turn, have a direct impact on heavy drinking and drinking problems. The model for Puerto Ricans suggests psychological motivations are the only direct predictor of drinking problems. For Dominicans, depression appears to be an important direct contributor to drinking problems, whereas for Colombians, acculturation seems to directly contribute to drinking problems. Implications for practice and research are discussed.

Comparing the Reliability of Difference Scores and Residuals in Analysis of Covariance

In pretest-posttest designs, residual scores created in the analysis of covariance commonly are preferred to difference scores because the latter suffer from reliability problems. This paper develops the reliability of residuals adjusted for a single covariate for comparison to the reliability of difference scores. Comparisons reveal that little is gained by analysis of covariance, which also suffers from reliability problems as the pretest and posttest reliabilities decrease and as their intercorrelation increases.

Cultural expression of psychiatric symptoms : Idioms of anger among Puerto Ricans

Increasing attention is being focused on the role of culture in psychological assessment and psychiatric diagnosis. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV, American Psychiatric Association, 1994), there are cultural considerations in applying the criteria of psychiatric disorders, as well as a glossary of culture-bound syndromes. There is a need for further research to clarify the cultural roots of expressive symptomatology. In the present study, focus groups conducted with Puerto Rican adults revealed that idioms of anger are salient to the mental health among a low socioeconomic status, inner-city population. Community and clinical samples of respondents (N = 531) were administered the idioms in a rating scale format. Factor analysis yielded dimensions expressive of aggression, assertiveness, and vindictiveness. These subscales correlated significantly with depressive and anxiety symptomatology, as measured by standardized instruments, and predicted clinical status. Results suggest that taking cultural expression of symptomatology into account enhances standard assessment of mental health.

Mental health status among Puerto Ricans, Mexican Americans, and non-Hispanic whites: The case of the misbegotten hypothesis

Challenged Shrout et al.s (1992) comparisons of mental health characteristics of island Puerto Ricans to Mexican Americans and non-Hispanic whites from the Los Angeles Epidemiological Catchment Area Study. The hypothesis tested by Shrout et al.--higher symptom counts but lower DSM-III prevalence rates among Puerto Ricans--was misattributed to Rogler (1989). We also question the validity of assessing lifetime prevalence and reaffirm the need for psychiatric epidemiological research to consider the role of culture in diagnostic criteria.