Multidisciplinary Mental Health Research Needs:

Emotional Health in Interethnic Contexts

David Rollock, Ph.D.Associate Professor of Psychological Sciences

Director of Clinical TrainingPurdue University

Brief Overview of Psychologists’ Roles as Health Care Professionals

• High costs of mental health problems– Pain and suffering– Financial costs: lost wages, mistaken med dx, etc.

• Distinctive roles of psychologists– Basic research– Assessment: cognitive, behavior analysis, diagnostic..– Psychotherapy/behavior management (vs. meds)– Treatment/program evaluation

• My interests: Minority mental health

– ALL behavior takes place in cultural context

Ethnocultural Issues in Mental Health

• DHHS Healthy People 2010 funding: – Increase quality & years of life– Eliminate demographic group disparities:

• Data: incidence/prevalence, service access, outcomes…• Special attention to ethnic minority mental health

• Cultural-Ecological approach (cf. Ogbu, 1981, 1995)– Groups foster skills for members’ expected roles– Internal/external influences on behavior/outcomes, e.g.,

• Globalization impact of intercultural contact & transition?

Theories of success

Mainstream relations

Existing skills

Implications of a Cultural-Ecological Approach to Minority Mental Health

• Mental health status– Symptom experience & expression

– Cultural contact/transition distress results from • match/mismatch of skills with new context• violations of expectations

• Mental health services– Decision to seek help– Preferred help sources—and compliance

Implications of a Cultural-Ecological Approach to Minority Mental Health

• Mental health research questions– Domains of culturally-developed skills & preferences

that could be helpful/problematic, e.g.,• Language• Values, beliefs

– Goals of contact/transition– Situations well- or ill-matched to skill/behavioral

repertoire – Within-group differences

• Gender, religion, generational status• Confounded group distinctions (e.g., nationality vs

“race”)

Research Program in Acculturation: Hispanics

• Fastest-growing ethnic minority group in U.S.

– Voluntary minority group (Ogbu), comprised of different groups across multiple generations

– Language use & demographics as predictors of depressive affect

– General vs. specific competence as predictors of depressive affect

Relationships among Acculturation, Competence, & Depression (Torres & Rollock,

2007)• What aspects of cultural transition

contribute to depression?– Intercultural competence as best

predictor of acculturative distress (> demographics, general coping, acculturation)(Torres & Rollock, 2004)

– Participants: 96 adults – Predictors: coping,competence,accult.– Criterion: depressive symptoms

• CONCLUSION:– General coping as crucial predictor!– Specific competence as key

moderator– Need to consider domains, goals

Research Program in Acculturation:South Asians

• Third largest/fastest-growing Asian group– Lack of research, despite group size– Perfect “laboratory” for acculturation

research• Ethnically distinct from mainstream• English language skills • Broader SES variations

• Investigations– Goals and expectations – Longitudinal research – Structure of standard depression measure

Culture Contact Goals as Predictors of Behavior Change & Depression (Rollock &

Rahman, 2007)• Do goals predict adoption of US behaviors &

depressive symptoms?– Plans to remain in US should be associated with greater

US acculturation– Plans to leave US should be associated with greater

traditional cultural retention– Plans to leave US should be associated with greater

depressive symptoms• Method:

– Participants: 149 SA male international students– Predictors: goals, ingroup & outgroup orientation

vars– Criterion variables: traditional customs, depressive

sx

Means (& SDs) and Mean Ranks of adjustment variables by cultural contact goal group

(n=149) Acculturation Goal

Adjustment Indicator

Return

Immediately (n = 14)

Reside in U.S. Temporarily

(n = 115)

Remain in U.S.

Permanently (n = 20)

(df = 2) MMRS Social Customs Mean (SD) 41.64 (6.66) 44.03 (6.45) 39.45 (4.35) Mean Rank 61.11 80.86 47.60 11.80** MMRS Language Usage Mean (SD) 17.14 (4.47) 18.08 (4.53) 15.05 (3.36) Mean Rank 71.14 79.81 46.60 10.39 CADC Intercultural Competence Mean 72.36 (16.81) 58.90 (17.23) 67.20 (20.12) Mean Rank 99.89 69.68 88.18 8.28* IEEI Public cultural values Mean (SD) 4.43 (0.90) 4.63 (0.82) 4.21 (0.90) Mean Rank 68.29 78.62 58.90 3.94 IEEI Mainstream/ Outgroup Identification Mean (SD) 3.65 (0.50) 3.69 (0.50) 3.89 (0.67) Mean Rank 70.18 73.73 85.65 1.52 CES-D Mean (SD) 24.21 (10.84) 17.73 (8.80) 22.25 (10.63) Mean Rank 97.04 69.76 89.70 7.68* RSES Mean (SD) 28.71 (3.77) 32.45 (5.13) 31.45 (5.89) Mean Rank 47.89 78.83 71.98 6.55* GPA Mean (SD) 3.39(0.60) 3.55 (0.35) 3.28 (0.41) Mean Rank 67.04 73.64 46.15 8.10* Months in U.S. Mean (SD) 18.00 (7.95) 19.57 (14.10) 90.20 (94.55) Mean Rank 69.54 68.54 108.08 14.86**

Predicting Traditional Social Customs Acceptance from Goals & Ethnic Identity

factors (n=149)

Predictor

B

S.E.

Wald 2

p

Odds Ratio

Goal 8.467 .014

Return immediately (vs. other stays) -.799 .721 1.228 .450

Temporary in USA (vs. permanent) 2.045 .737 7.703 .006 7.728

IEEI Ethnic Food Preference 1.239 .375 10.924 .001 3.453

IEEI Public Cultural Values .666 .320 4.319 .038 1.946

IEEI Mainstream/Outgroup Identification -.419 .437 .920 .657

IEEI Ingroup Loyalty -.180 .288 .392 .835

IEEI Ingroup Information-Seeking .335 .192 3.039 1.398

IEEI Caution about Ingroup -.122 .171 .508 .885

All Degrees of Freedom = 1, except for Goal (df = 2).

Predicting Depressive Symptoms from Goals & Ethnic Identity factors

Predictor

B

S.E.

Wald 2

p

Odds Ratio

Goal 6.644 .036

Return immediately (vs. other stays) 1.748 0.716 5.971 .015 5.746

Temporary in USA (vs. permanent) -.639 .574 1.238 .528

IEEI Ethnic Food Preference .473 .283 2.793 1.605

IEEI Public Cultural Values .393 .284 1.918 1.481

IEEI Mainstream/Outgroup Identification .629 .284 4.916 .027 1.875

IEEI Ingroup Loyalty -.216 .284 .576 .806

IEEI Ingroup Information-Seeking .100 .171 .339 1.105

IEEI Caution about Ingroup .578 .169 11.669 .001 1.783

All Degrees of Freedom = 1, except for Goal (df = 2).

Acculturation Research Conclusions So Far

• Cultural skill development & retention reflect expected place in a given culture

• Goals must be considered, as much as (simple) cultural exposure

• Mismatch of goals and context leads to distress

• Next steps– Identify specific preferred skills– Identify changes in goals (& skills) over time

Research Program in Interethnic Emotion: “Race”-Related Police

Contact• Mental health implications of contact with

law enforcement in communities of color• Safety & security vs oppression &

disempowerment

– Types of contact– Basic responses: prevention mechanism vs

secondary traumatization– Implicit attitudes as action potentials– Transmission of attitudes to children, adults

Additional Opportunities for Multidisciplinary Collaboration in

Clinical Psychology• Connecting researchers & practitioners

– Aggregating data across practitioners on “what works”

– Tracking service utilization• Improving assessment

– Automated CPTs to assess attention (McClellan)– Technology to aid manipulation of materials

• Evidence-Based Interventions– Symptom sampling in hard-to-reach groups– Monitoring dose-response