Stephanie T. Nishimura

Prediction of anxiety disorders using the State-Trait Anxiety Inventory for multiethnic adolescents

The purpose of this study was to determine the validity of the State-Trait Anxiety Inventory (STAI) in predicting DSM-III-R anxiety disorders based on the Diagnostic Interview Schedule for Children (DISC, Version 2.3) and using Asian/Pacific Islander adolescents. An overall prevalence rate of 9.19% for generalized anxiety disorder, overanxious disorder, or social phobia was consistent with past studies. As hypothesized, STAI negatively worded (i.e., Factor 2) items were better predictors than positively stated (i.e., Factor 1) items. The STAI State mean was a better predictor of concurrent DISC anxiety disorders as compared to STAI State Factors I or 2. In contrast, the STAI Trait Factor 2 (negatively worded) composite was the best predictor for nonconcurrent DISC anxiety disorders as compared to STAI Trait Factor 1 or the overall STAI Trait subscale. Satisfactory predictive-validity values were obtained when using the STAI State mean and Trait Factor 2 composite. Implications of these findings are discussed, including using the STAI as a screening measure for ethnically diverse adolescents.

Adolescent alcohol use and suicide indicators among adolescents in Hawaii

Research on suicide has focused on gender, age, ethnicity, and psychiatric profiles. However, few studies have examined alcohol use and its relationship to suicide among Native Hawaiians and other Asian American/Pacific Islanders. This study analyzes data from the 1997 and 1999 Hawaii Youth Risk Behavior Survey to examine whether alcohol problems increase the risk for suicide indicators (as evidenced by responses to questions asking whether an individual has considered, planned, attempted, or required treatment for a suicide attempt). Drinking pattern was the best predictor for all suicide indicators. School and community-based programs can help to increase an adolescents knowledge about the consequences of alcohol use and prevention of suicide.

A conceptual model of cultural predictors of anxiety among Japanese American and part-Japanese American adolescents.

A model integrating Japanese ethnicity, cultural identity, and anxiety was developed and assessed in Japanese American and part-Japanese American high school seniors (N = 141). Using measures from the Hawaiian High Schools Health Survey, the model incorporated the State-Trait Anxiety Inventory, the Major Life Events Scale, and the Japanese Culture Scale (JCS). Japanese American adolescents scored higher on the JCS and reported fewer anxiety symptoms than part-Japanese American adolescents. Predictors for anxiety were being Japanese American versus part-Japanese American, income, and culturally intensified events. A significant interaction of behavior by self-identification was obtained. The model had good overall fit, suggesting that cultural identity formation may contribute to anxiety experienced particularly by adolescents of mixed heritage.

Variation in self-esteem among adolescents in an Asian/Pacific-Islander sample

Abstract Variation in global self-esteem among adolescents differentiated in terms of age, gender, Hawaiian/part-Hawaiian and non-Hawaiian ethnicity, self-reported grades (SRGs) and socioeconomic status (SES) was examined in the present study. Being older, male or non-Hawaiian and higher SRGs or SES were hypothesized to be associated with higher global self-esteem. Six hundred and ninety-six Hawaiian/part-Hawaiian and non-Hawaiian high school students provided responses to demographic items, the 10-item Rosenberg Self-Esteem Scale [RSES; Rosenberg, M. (1965). Society and the adolescent self-image . Princeton, NJ: Princeton University Press], and items assessing SRGs and SES. Adolescent males reported significantly higher self-esteem than adolescent females. Adolescents differing in SRGs and SES also varied significantly from one another in self-esteem, with the general pattern indicating higher SRGs and SES to be associated with higher self-esteem. The significant age-by-SRGs interaction effect suggested the consequence of academic success throughout the high school years. Findings regarding the present Asian/Pacific-Islander adolescent sample corresponded with that found for other adolescent samples of different ethnic compositions, which provided support for the generalizability of variation in global self-esteem and its noted correlates across various socio-cultural contexts.

Demographic and Social Variables Associated with Psychiatric and School-Related Indicators for Asian/Pacific-Islander Adolescents

Background: Factors associated with Asian/Pacific-Islander adolescent adjustment is a greatly neglected research area. Aims: The purpose of the present study was to investigate the relation between demographic, social and adjustment measures based on a large-scale investigation of Asian/Pacific-Islander youths. Method: A total of 2577 adolescents were surveyed across 4 public schools in Hawai‘i during the 1992-1993 school year. Results: Three social variables (number of relatives frequently seen, family support and friends’ support) exhibited statistically significant but low correlations. Family support had the highest negative association with the four psychiatric symptoms (depression, anxiety, aggression, substance use). Friends’ support was inconsistently associated with the adjustment measures, and the number of relatives frequently seen resulted in negligible effects. In contrast, demographic variables, especially ethnicity, played a much greater role in the association with the four school-related measures (grade-point average, absences, suspensions, conduct infractions). Discussion: For Asian/Pacific-Islander youths, the quality of the social supports, including family relations, may be particularly important in the adolescents’ adjustment. When examining school-related outcomes, demographic variables, with particular emphases on ethnicity and culture, must be considered. When developing and implementing prevention and intervention services and programs, consideration of family and ethnic-cultural influences should be taken into account, with further research needed in several related domains: other SES influences, life stressors, migration-generational effects, ethnic identity, self-concept indicators and socio-political aspects.

Path models linking correlates of self-esteem in a multi-ethnic adolescent sample

Abstract Path analysis was performed to delineate the interrelations between state anxiety, aggression, substance abuse, depression, gender, ethnicity, family support, and self-esteem in a sample of 684 Hawaiian/part-Hawaiian and non-Hawaiian (e.g. Caucasian, Filipino, Hispanic, Japanese, or Mixed/two or more ethnicities) adolescents. The theorized model proposed that self-esteem was determined by family support and gender, and that family support, in turn, was predicted by state anxiety, aggression, substance abuse, depression, and ethnicity. The derivation of this model was based on previously documented findings of the associations between self-esteem and indices of adolescent adjustment, theorized multi-directionality of these interrelations, non-existence of an exhaustive theory accounting for the predictive links between these variables, and centrality of the ohana or family system and its integral network of support within the Native-Hawaiian culture. Goodness-of-fit indices indicated a poor fit between the theorized model and data. Subsequent model modifications were based on succeeding path analytical results, and conjointly encompassed an effort to find a model that fit the data well. Changes to the theorized model included eliminating three paths (i.e. from aggression and ethnicity to family support and from gender to self-esteem), and adding three paths (i.e. from depression, state anxiety, and aggression to self-esteem). The retained “final” Model 6 fit the data very well, and delineated the prediction of self-esteem by depression, state anxiety, aggression, and family support, which was, in turn, determined by depression, state anxiety, and substance use.

A confirmatory model for depression among Japanese American and part-Japanese American adolescents.

A confirmatory model integrating Japanese ethnicity, cultural identity, and depression was developed (N = 140). The model incorporated the Center for Epidemiologic Studies-Depression Scale (CES-D), Major Life Events Scale, and Japanese Cultural Scale. Japanese American adolescents scored higher on the Japanese Cultural Scale and reported fewer depressive symptoms on the CES-D total and on 2 of the 3 CES-D factors than part-Japanese American adolescents. Predictors for depression were being Japanese American vs. part-Japanese American, female gender, and culturally intensified events. A significant interaction of behavior by self-identification was noted. The model had good overall fit and suggested that the formation of cultural identity may contribute to depressive symptoms experienced by adolescents, particularly adolescents of mixed heritage.

Prediction of DISC substance abuse and dependency for ethnically diverse adolescents

PURPOSE This study examines the validity of selected items from the Substance Abuse Subtle Screening Inventory-Adolescent (SASSI-A) version in predicting Diagnostic Interview Schedule for Children (DISC version 2.3) Substance abuse and dependency (SA/D) for Native Hawaiian (i.e., indigenous people of the Hawaiian Islands) and non-Hawaiian adolescents (youth without any Native Hawaiian indigenous ancestry). METHODS 542 students were randomly selected from the larger sample to participate in the DISC administration. Demographic information, SASSI-A scores, and DISC diagnoses were obtained for each student. Univariate and multiple logistic regressions were performed in the prediction of DISC SA/D. RESULTS SASSI-A Factor 1, consisting of three items measuring substance use, was found to have the best utility, accounting for 18.1% of the variance, in predicting DISC SA/D. IMPLICATIONS These results support selected SASSI-A items in screening for SA/D for Native Hawaiian and non-Hawaiian adolescents in Hawaii as compared to other community-based screening instruments for other populations.

Equivalencies Regarding the Measurement and Constructs of Self-Esteem and Major Life Events in an Asian-Pacific Islander Sampler.

Construct, scalar, and functional measurement equivalencies of the Rosenberg Self-Esteem Scale (RSES) and Major Life Events checklist (MLE) and the constructs assessed were investigated across groups differentiated on Hawaiian/part-Hawaiian and non-Hawaiian (e.g., Caucasian, Filipino, Hispanic, Japanese, and mixed/2 or more) ethnicity and gender. Initial results from maximum likelihood factoring with promax rotation showed that RSES negatively worded Item 5 loaded with the positively worded Items 1, 2, 4, 6, and 7 on 1 of 2 factors for Hawaiian/part-Hawaiian female participants. Similarly, negatively worded Item 8 and the same positively worded items comprised 1 of 2 factors for non-Hawaiian male participants. For the other 2 Ethnicity x Gender groups, factors were respectively comprised of the 5 positively and 5 negatively worded RSES items. Construct equivalence or simple (2-factor) structure underlying the RSES was indicated across the 4 groups after Items 5 and 8 were excluded from a subsequent factoring procedure. Simple structure showed that Factor 1 comprised the positively worded Items 1, 2, 4, 6, and 7, and the remaining negatively worded Items 3, 9, and 10 loaded on Factor 2. Scalar equivalence of the self-esteem and major life events measures was supported by the statistical nonsignificance of the Major Life Events x Ethnicity x Gender interaction effect in multiple regression models. The consistency in the absolute size and direction of the intercorrelations between overall self-esteem, self-esteem Factors 1 and 2, and major life events variables indicated the functional equivalence of respective measures and constructs assessed. Measurement equivalency findings concerning the RSES and MLE, the constructs measured, and their utility versus caution against their use in multiethnic studies were discussed.

Dating Violence Victimization Among Asian American and Pacific Islander Youth in Hawai‘i

ABSTRACT Recent studies reported high levels of adolescent dating violence, which led federal agencies to define this area as a public health issue. Most studies fail to include Asian American or Pacific Islander youth in ways that provide for accurate analysis. The present study examined verbal and psychological dating violence victimization prevalences among 2 Asian American (Filipino, Japanese) and 2 Pacific Islander (Native Hawaiian, Samoan) adolescent groups. The results showed 58.3% reported experiencing emotional dating violence, with 43.7% affirming that they experienced insulting/verbal abuse and 43.3% reporting that they were victims of controlling behaviors. No significant differences were found for victimization rates and severity by gender. This study highlights the need for research to examine dating violence among this population.