The Relationship among Family Cohesion, Gender, Level of Acculturation, and

Depression in Latino Adolescents

Dissertation

Submitted to Northcentral University

Graduate Faculty of the School of Behavioral and Health Sciences

in Partial Fulfillment of the
Requirements for the Degree of

DOCTOR OF PHILOSOPHY

by

SCOTT MURDOCK WILLIAMS

Prescott Valley, Arizona

May, 2010
 UMI Number: 3411278

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Scott Murdock Williams

 APPROVAL PAGE

The Relationship among Family Cohesion, Gender, Level of Acculturation, and

Depression in Latino Adolescents
by
Scott Murdock Williams

Approved by:

Chair: Nora Young, P h . t ^ /r\ Date

Member: Eva Mika, Ph.D.

Member: Miguel Fernandez, Ph.D.

Certified by:

School Dean: Heather Frederick, Ph.D. Date

 ABSTRACT

Adolescent depression has been shown to relate to numerous negative outcomes,

including difficulty with psychosocial adjustment, substance abuse, increased risk of

depression in adulthood, and suicide. By mid-adolescence, twice as many girls than boys

of all ethnicities experience depression. Furthermore, Latino adolescents have higher

rates of depression than any other cultural group. Latina females are the highest risk

group of adolescents, experiencing more depressive symptoms than Latino males and

both genders of all American cultures. The purpose of the study was to identify variables

that influence depression among Latino adolescents. A quantitative research design with

a cross-sectional descriptive correlational method was utilized. A secondary dataset from

the Latino Adolescent Development research project of California State University

Northridge collected at a Los Angeles, California high school was used. A convenience

sample size of 400 students from this dataset was analyzed to examine the relationship

among family cohesion, level of acculturation, and depression. The results revealed that

family cohesion was significantly and negatively related to adolescent depression (r = -

.33; p <.001). Females reported significantly higher levels of depressed mood than males

(r = -.26; p < .001). Gender did not have a moderating effect on the relationship between

family cohesion and depression {beta = .03, p = .57). Level of acculturation was not

significantly related to depressed mood (r = -.06; p = .14). Thefindingsindicate that

increased family cohesion in Latino families decreases the possibility of adolescent

depression, and that Latina female adolescents experience depressive symptoms at a

much higher rate than Latino males. They also indicate that family cohesion and gender

each have their own relationship with depression, but do not influence one another. There

iv
is also the indication that increased level of acculturation does not result in depressive

symptoms for all Latino adolescents. Suggestions for future studies include collecting

data from Latinos in different schools, with different adolescent age groups, and in

different geographic locations to determine if the results are unique to this specific

sample or can be generalized to all Latino adolescents. An acculturation scale could be

used to assess level of acculturation.

v
 ACKNOWLEDGEMENTS

It is with appreciation that I would like to thank everyone who has contributed to

my doctoral pursuit and success. Dr. Nora Young has been so much more than an

excellent dissertation chair. As a quality person and sacrificial mentor she taught me new

lessons about perseverance, excellence, and laughter. Drs. Eva Mika and Miguel

Fernandez, my other committee members, always had my best in mind.

Nobody sacrificed more for me to pursue and succeed at my dream than my wife,

partner, friend, and colleague Wendy Hill Williams. Her love for me is unparalleled. I

look forward to giving more to her as she finishes her doctoral dissertation. To my

children, Caitlin and Garrett, I hope the many hours of burying my head in my studies

have taught them to keep trying until they succeed. I appreciate the years of family

investment my parents Doc and Audrey have made, and my sister Kathy for being a good

friend and believing I could actually finish. In memory of my former mother-in-law, I am

thankful for Lavenia Hill, who believed in my ability to achieve my dreams when I first

joined their family. Everyone should be so fortunate to have in-laws like Dr. Carl and

Lorie Hill who have supported me as they would their own child.

I would like to thank the entire California State University Northridge

community. Unfortunately, I cannot acknowledge everyone by name. Dr. Scott Plunkett's

caring style and high professional standards have transformed me into a scholar. Family

and Consumer Sciences department chairs Drs. Audrey Clark and Alyce Akers believed I

could earn my doctorate as a mid-career professional. Dr. Clark saw my potential as an

educator before I did and has always inspired me to succeed. Our new department chair

Dr. Allen Martin, and our college's assistant dean Dr. Marilyn Filbeck, have continually

vi
prodded and supported me for seven years. Diane Lewis-Goldstein has been my fellow

mid-career doctoral student. Thanks to all my professor colleagues for being excellent

role models and to my students for revealing their family lives and the values of their rich

ethnic heritage. Drs. Gary Sattler and Jim Guy have been a tremendous personal support.

Finally Jean O'Sullivan, my trustworthy professional editor, has only been satisfied with

strict adherence to APA standards.

vii
 TABLE OF CONTENTS

LIST OF TABLES x

LIST OF FIGURES xi

CHAPTER 1: INTRODUCTION 1
Background 2
Problem Statement 4
Purpose 6
Theoretical Framework 7
Research Questions 11
Hypotheses... 11
Nature of the Study 12
Significance of the Study 14
Definitions 14
Summary 17
CHAPTER 2: LITERATURE REVIEW 18
Introduction to Literature Review 18
The Adolescent 19
Adolescent Depression 20
Family Factors and Adolescent Depression 27
Latino Culture and Families 31
Depression in the Latino Adolescent 36
Acculturation, Generation Status, and Depression 38
Gender and Depression 43
Summary 50
CHAPTER 3: RESEARCH METHOD 52
Research Method and Design 54
Participants 56
Materials/Instruments 58
Operational Definition of Variables 64
Data Collection, Processing, and Analysis 65
Methodological, Assumptions, Limitations, and Delimitations 70
Ethical Assurances 71
Summary 73
CHAPTER 4: FINDINGS 75
Results 75
Evaluation of Findings 81
Summary 84
CHAPTER 5: IMPLICATIONS, RECOMMENDATIONS, AND CONCLUSIONS 86
Implications 88
Recommendations 94

viii
 Conclusions 95

REFERENCES 97

APPENDIXES 118
Appendix A: Demographic Questionnaire... 119
Appendix B: The Family Environmental Scale 120
Appendix C: The CES-D Scale 121

ix
 LIST OF TABLES

Table 1 Correlations and Descriptive Statistics 75

Table 2 Hierarchical Multiple Regression Analyses 79

x
 LIST OF FIGURES

Figure 1. Scatter Plot of Family Cohesion and Depression 76

Figure 2. Mean Depression of Females and Males 77

Figure 3. Histogram of Generation Status and Depression 78

Figure 4. Hierarchical Multiple Regression Analyses for Latino Adolescents' Perceptions

of Family Cohesion, Gender, and Depressive Symptoms 80

xi
 1

CHAPTER 1: INTRODUCTION

Depression in adolescents is of concern to the general population as evidenced by

the number of television programs and websites on this topic (Costello, Erkanli, &

Angold, 2006). The number of prescriptions for antidepressant medications for children

and adolescents increased over five times from 1987 to 1996 (Zito et al. 2003). There are

conflicting results in the literature as to whether the prevalence of depression in

adolescents has increased (Lewinsohn, Rohde, Seeley, & Fischer, 1993; Son & Kirchner,

2000) or remained the same (Costello et al., 2006) over the past 30 years. However, even

if the prevalence of depression has remained the same, the population growth in the

United States would indicate that the number of depressed adolescents has risen.

Among all ethnic subgroups in the United States, Latino adolescents have the

highest rate of depression (Substance Abuse and Mental Health Services Administration

[SAMHSA], 2008). In particular, Latina girls experience depression at a higher rate than

Latino boys and all other adolescent subgroups (Barrera, 2006). This is consistent with

research data that in the United States adolescent girls experience a higher rate of

depression than adolescent boys (Buzi, Weinman, & Smith, 2007; Son & Kirchner). If

the rate of depression among Latino adolescents continues, there will be an increase in

the number of depressed adolescents from this ethnic subgroup. This is because the U. S.

Bureau of the Census (2008) projects the population of Latinos, the largest minority in

the United States, will nearly triple from 46.7 to 132.8 million by the year 2050.

Various factors are related to depression in Latino adolescents. Acculturation, the process

of leaving one's culture and joining a new culture, has been correlated with depression

(Halgunseth, 2004). Yet it is second generation Latino adolescents that experiences

 2

higher levels of depression and suicide than first generation (Pena,Wyman, & Brown,

2008). It is possible that the Latino cultural values that emphasize closeness and cohesion

among family members may be a protective factor related to the decreased incidence of

depression in first generation adolescents. However, few studies to date have examined

the relationship between family cohesion and depression in first and second generation

Latinos.

This chapter provides a background overview and explanation of the research

topic. The problem statement and purpose statement identify the need and intent of the

study. An overview of the three theories utilized in the study is described in the

theoretical framework section. Four research questions and hypotheses, along with their

corresponding null and alternative hypotheses, are stated in testable form. The section on

the nature of the study briefly describes the study design, variables, instruments, and

analyses of the data. The section on the significance of the study demonstrates the

important contribution the research will make to the field of Latino adolescent

development. The chapter concludes with definitions of key operational terms relevant to

the study.

Background

Adolescent depression has been conceptualized and organized into four historical

phases (Speier, Sherak, Hirsch, & Cantwell, 1995). Phase 1 was heavily influenced by

psychoanalytic thought. It was believed that it was not possible to experience clinical

depression until adulthood because only then was the superego fully developed. The

common thinking of this phase persisted until the 1960s. Phase 2 emerged in the late

1960s with the recognition of the possibility that depression could occur in children and
 3

adolescents, but that youth and adults experienced different symptoms. Phase 3, during

the 1970s, explored how depression in childhood and adolescence was disguised by other

symptomatic behaviors (e.g., learning disabilities). Phase 4 began in the 1980s and

established that the symptoms of depression are similar in children and adults and that

any differences are reflective of specific developmental stages (Speier, Sherak, Hirsch, &

Cantwell, 1995). Many studies conducted during this phase examined the relationship

among psychosocial influences and depression in adolescents.

One theme of these emergent studies involved the influence of the family on

adolescent depression. In a study that examined the relationship among family factors,

self-esteem, and depression, Robertson and Simons (1989) found that perceived parental

rejection was related to adolescent depression. In their discussion they posited that

parental rejection decreased self-esteem over time and subsequently lead to depression.

They suggested that this depression developed in response to family environment that

was perceived to be excessive in parental criticism and shaming. Copeland (1999)

examined the relationship among adolescent depression and five family components: (a)

family functioning, (b) family structure, (c) parental depression, (d) socioeconomic

status, and (e) ethnicity. In addition to studying the influence of the family on adolescent

depression, scholars began to examine additional psychosocial influences. During the

1990s, scholars who had limited their population samples to depressed adults broadened

their selection to include children and adolescents. The relationship between gender and

depression in adults was well defined by the 1980s (Nolen-Hoeksema, 1990), yet in the

1990s scholars began to examine this in greater detail with samples of children and

adolescence. Nolen-Hoeksema (2001), in her review of literature, identifies many of the

 4

variables that were included in these studies: (a) victimization, (b) chronic strains of

everyday life, (c) gender intensification in adolescence, (d) self-concept, and (e) coping

styles. Longitudinal studies began to emerge, such as the one by Hankin et al. (1998).

They used a prospective method to investigate the emergence of gender differences in

clinical depression and to learn about the development of depression from preadolescence

through adolescence. In the 1990s scholars broadened their focus to include samples of

adolescents from non-Caucasian cultures.

Historically, research on adolescent depression had been conducted utilizing

primarily European-American samples. In the 1990's studies began to emerge comparing

symptoms of depression in European, African, and Latino American adolescents (Roberts

& Sobhan, 1992). Around the same period of time, research was also conducted on the

influence of acculturation and acculturative stress on depression and overall mental

health in Latino immigrant families (Rogler, Cortes, & Malgady, 1991). Hovey and King

(1996) compared the influence of acculturative stress on depression and suicidal ideation

in first- and second-generation Latino adolescents. Twenty-five percent of those surveyed

had suicidal ideation and a high level of depression, which was positively correlated with

acculturative stress.

Problem Statement

The prevalence of depression in preadolescent children is low but rises in

adolescence (Lewinsohn, Rohde, & Seeley, 1998). The problem of adolescent depression

is of concern because it has been shown to relate to numerous negative outcomes,

including difficulty with psychosocial adjustment, substance abuse, as well as increased

suicidal ideation and attempts (Paradis, Reinherz, Giaconia, & Fitzmaurice, 2006). In
 5

addition, depression in adolescence is associated with increased risk of depression and

suicide attempts in adulthood (Lewinsohn, Rohde, Klein, & Seeley, 1999). As previously

noted, Latino adolescents have the highest rates of depressive symptoms of all cultural

groups in the United States and female Latino adolescents have a higher rate of

depressive symptoms than their male counterparts (SAMHSA, 2008). Interestingly,

depression has been shown to be higher in second-generation Latino adolescents (Singh

& Hiatt, 2006). Since acculturative stress is correlated with depression (Chapman &

Perreira, 2005), it is possible that Latino adolescents who live in families with a higher

level of acculturation are more likely to experience depression than those who live in

families with lower levels of acculturation. This apparently contradictory statement may

have to do with the adoption of the host culture's values of independence and

disengagement, and minimizing traditional Latino values that serve as a protective value

against depression.

The importance of family in Latino culture increases the possibility that loss of

family cohesion might be a predictor of depression (Miranda, Estrada, & Firpo-Jimenez,

2000). The correlation between family cohesion and depression has been studied in

Caucasian families, yet it is relatively unknown in Latino families (Clark et al., 2007;

Kelch-Oliver, Smith, Diaz, & Collins, 2007; Vazsonyi & Belliston, 2006). In addition, it

is uncertain if the gender of the Latino adolescent moderates the relationship between

family cohesion and depression. It appears that no studies to date have examined the

variables in the relationship among family cohesion, gender, level of acculturation, and

depression in Latino adolescents, and whether the adolescent's gender is a moderating

variable.
 6

Purpose

The purpose of this study was to determine if there was a significant relationship

among family cohesion, gender, level of acculturation, and depression in Latino

adolescents, and to determine if gender moderated the relationship between family

cohesion and depression. Adolescent peer support and socioeconomic status are potential

confounding variables. It is possible that peer support increases as family cohesion

increases, influencing the level of depression experienced by the adolescent. The opposite

is also possible. As family cohesion decreases the adolescent may turn to peers for social

support affecting the level of depression. Low socioeconomic status and the affects of

poverty potentially could increase the level of depression in Latino adolescents. A

quantitative research design utilizing a cross-sectional descriptive correlational method

was used. The relationship among the independent variables (family cohesion, gender,

and level of acculturation) and the dependent variable (depression) were examined in a

convenience sample of Latino adolescents. A secondary dataset was obtained from the

Latino Adolescent Development project at California State University Northridge. The

project investigators collected their data from adolescents at a Los Angeles, California

high school in the spring and summer sessions of 2006. Of the 659 high school students

who participated in the project, 400 were identified as Latino, 99.2 % were in ninth grade

and 0.8 % in 10th. To assess family cohesion, the Latino Adolescent Development

primary investigators used a nine-item modification of the Cohesion subscale of the

Family Environment Scale (FES) created by Moos and Moos (1994). To assess

depression, they used Radloff s (1977) 20-item Center for Epidemiologic Study Inventory

(CES-D) for depressed mood.

 7

Theoretical Framework

Three theoretical perspectives influenced the study: (a) lifecycle developmental

theory, (b) human ecological theory, and (c) family systems theory. The lifecycle

developmental theory views human development in stages that occur from birth through

old age. The lifecycle framework is one of the most frequently used concepts in the social

and behavioral sciences (O'Rand & Krecker, 1990). The roots of the concept emerged in

the 19th century from various disciplines: (a) biology, (b) social philosophy, and (c) early

developmental psychology (Coleman, 1971).

Each discipline had its own specific contribution to the lifecycle developmental

theory. From biology, lifecycle theorists implemented examining how a person's

development is similar or dissimilar to others in a cohort of people (Coleman, 1971).

From social philosophy, lifecycle developmentalists integrated the exploration of the

origins and evolution of different family forms (Leibovitz, 1969). Lifespan theorists

expanded the time frame of developmental psychology to examine how an individual

develops from conception through old age (Baltes, 1979). From these early contributions

emerged the two important concepts in lifespan development of life span and life course.

Life span involves the duration or maximum life potential of an average individual

beginning at birth and ending at death. Life course addresses the sequencing and timing

of stages as the individual matures (Elder, 1978). Therefore at stages throughout life, an

individual must master various challenges, acquire specific skills, and accomplish

milestones to successfully mature (Berk, 2004). Emphasis on the passage of time is not

the emphasis of human ecological theory.

 8

Human ecological theory emphasizes the interdependence of systems that

influence an individual's growth and development (Bronfenbrenner, 2005). The theory is

unique because it addresses humans as both biological and social beings that interact with

their environment. Human ecological theory addresses a diverse group of human

populations, with family ecological theory being a component that has specific

applications to the family. The family is viewed as an energy transforming system

interdependent with numerous systems. Particular emphasis is given to the family's

ability to create, use, and manage resources that facilitate adaptation, maturation, and

sustaining environmental systems (Bubolz & Sontag, 1993). Therefore the family has a

reciprocating relationship with multiple systems.

Bronfenbrenner (2005), a key contributor to human ecological theory, views the

individual as interconnected in a reciprocal bi-directional relationship with different

ecological systems including the family, school or work, community, and culture. His

approach provides a context for researchers to understand the various ecological niches

that influence the participants' development and life experience. Understanding the

individual and family with an ecological perspective emerged in the latter part of the

nineteenth century.

The last half of the 19th century was a period of industrialization and urbanization

that lead to social reform (Bubolz & Sontag, 1993). Reform occurred because of the

emerging assumption that humans exist in context of the total life system and can only be

fully understood by knowing the environments that surround them (Andrews, Bubolz, &

Paolucci, 1981). Key areas of social reform included the expansion of public education

and increased concern about the overall welfare of families. This ecological perspective
 9

was renewed in the 1960s as an isolated view of individuals and families was replaced

the interdependence of all human actions (Andrews, et al., 1981). This interdependence is

also found in family systems theory.

Family systems theory views family members as interconnected with one another.

The family is a system that is distinct from other systems that exist in the community and

culture. To fully understand an individual in a family, the interactions among all

members must be analyzed. Individuals join with others to form subsystems, whose

function is to carry out roles and tasks essential to the life and survival of the family

(Smith, Hamon, Ingoldsby, & Miller, 2008; Whitchurch & Constantine, 1993). The

Circumplex Model (Olson & Gorall, 2003), a sub-theory of family systems theory,

addresses the degree of flexibility and cohesion in the family. Family systems theory

emerged from numerous schools of thought.

Two theories that shaped the genesis of family systems theory were structural

functionalism and general systems theory. The premise of structural functionalism, a

highly influential model in sociology for over 30 years through the 1960s, is that social

causes create specific effects. The relationship between these two variables was seen as

linear and did not include the bi-directional influences of a systems perspective

(Broderick, 1993). During this same era a new paradigm emerged for the analysis of

complex systems. General systems theory emphasized the interaction among all parts of a

system, gaining such popularity among scholars that it soon merged with cybernetics, the

science of self-correcting systems. The development of family systems theory gave birth

to the family therapy movement (Broderick, 1993). The development of each theory has

created challenges for today's scholars.

 10

Current issues in these three theories address the many changes that have occurred

since their inception. In the lifecycle developmental theory, there has emerged a gap

between theory and research. While the theory emphasizes role trajectories, transitions,

the timing and ordering of events in a normative life course, the empirical results of

research rarely describe the life cycle in such consistent and homogeneous ways. As

debate continues, scholars argue that the overall structure of the life cycle has become

progressively individualized and often categorized by geographical location and social

position (Macmillan, 2005). The challenges that lifecycle developmental theorists face

are similar to those encountered by human ecological and family system theorists.

Human ecological theory and family systems theory share common roots. The

major theoretical underpinnings of both are derived from systems models. They are

dynamic in their orientation and emphasize process and content (O'Brien, 2005). Today's

scholars from each theory emphasize that the analytic strategies used to understand and

create change within a system are not consistent with the theoretical assumptions. They

argue that current methods focus on the main effects or outcome, and have drifted away

from moderating and mediating the process. Today's scholars believe the focus must be

on within-group variability and the origins of the variability, and determining the

interrelated patterns of change among individuals, families, and social environments

(O'Brien, 2005).

The three theories of the study, lifecycle developmental theory, human ecological

theory, and family system theory, provided a strong foundation for the study. Both the

population selected and the independent variables of the study have been examined by
 11

scholars from each theoretical orientation. By utilizing these three theories, the research

provides a broader and more holistic understanding of depression in Latino adolescents.

Research Questions

In preadolescent children thefrequencyof depression is low but rises in

adolescence (Lewinsohn, et al., 1998). Among all ethnic groups, twice as many girls than

boys experience depression my mid-adolescence (Hazier & Mellin, 2004). In particular,

Latino adolescents have higher rates of depression than any other cultural group. Latina

females are the most high-risk group of adolescents and experience more depressive

symptoms than Latino males and both genders of all American cultures (Barrera, 2006).

To address this problem of depression among Latino adolescents, the following four

research questions were proposed for the study. It was proposed that if there was a

relationship between gender and depression then the third question would be investigated.

Ql: What is the relationship between family cohesion and depression among

Latino adolescents?

Q2: What is the relationship between gender and depression among Latino

adolescents?

Q3: Does the gender of the Latino adolescent moderate the relationship between

their reports of family cohesion and its effect on depression?

Q4: What is the relationship between level of acculturation and depression among

Latino adolescents?

Hypotheses

The following are the null and alternative hypotheses for each research question:
 12

Hlo'- There is no relationship between family cohesion and depression among

Latino adolescents.

Hla: There is a relationship between family cohesion and depression among

Latino adolescents.

H2o. There is no relationship between gender and depression among Latino

adolescents. Females are not more likely than males to develop symptoms of depression.

H2a: There is a relationship between gender and depression among Latino

adolescents. Females are more likely than males to develop symptoms of depression.

H3o'- The gender of the adolescent will not moderate the relationship between

their reports of family cohesion and depression.

H3a: The gender of the adolescent will moderate the relationship between their

reports of family cohesion and depression.

H4(f. There is no relationship between level of acculturation and depression

among Latino adolescents. Latino adolescents who live in a family with a higher level of

acculturation are not more likely to experience depression than those who live in a family

with a lower level of acculturation.

H4a: There is a relationship between level of acculturation and depression among

Latino adolescents. Latino adolescents who live in a family with a higher level of

acculturation are more likely to experience depression than those who live in a family

with a lower level of acculturation.

Nature of the Study

A quantitative research design with a cross-sectional descriptive correlational

method was used for this study. A secondary dataset from the Latino Adolescent
 13

Development research project of California State University Northridge at a Los Angeles,

California high school was utilized. A convenience sample size of 400 students from this

dataset was analyzed to examine the relationship among family cohesion, level of

acculturation, and depression. To assess family cohesion, the Latino Adolescent

Development primary investigators used a nine-item modification of the Cohesion

subscale of the Family Environment Scale (FES) created by Moos and Moos (1994). To

assess depression, they used Radloff s (1977) 20-item Center for Epidemiologic Studies

Depression Scale (CES-D) for depressed mood.

Zero-order correlations (i.e., Pearson's correlations) were used to examine the

bivariate relationships between generation status of the adolescent, gender of the

adolescent, family cohesion, and depressed mood. Pearson's correlation coefficients were

used to determine if there was a positive or negative relationship between two variables

that were continuous in nature. A hierarchical multiple regression analysis was conducted

to determine the main effects and direction each variable had on depression and to

explain how much variance each variable accounted for depression. Family cohesion,

gender, and level of acculturation were entered into the regression equation during the

first step. The second step of the regression analysis was to determine the interactive

effects of these variables. Family cohesion, gender, level of acculturation, and gender X

family cohesion was entered into the regression equation. This facilitated examination of

the additional variance explained by the interaction beyond gender and family cohesion

and to test possible moderation.

 14

Significance of the Study

The completion of this research study is important as it represents a contribution

to different fields. Through increased awareness of the risk factors for depression in

Latino adolescents, clinical practitioners who work with families from diverse ethnic

backgrounds will be helped with positive outcomes (Arbona & Power, 2003). Mental

health providers may improve the delivery of their services through a greater

understanding of the generational similarities and differences in Latinos (Abe-Kim, et al.,

2007). It may also benefit the best practices for intervention programs with youth at risk

for depression (Brendgen, Wanner, Morin, & Vitaro, 2005). Depression is a major public

health concern affecting twice as many women as men (Le, Munoz, Ippen, & Stoddard,

2003). This study can influence the effective implementation of public policy aimed at

reducing the impact of depression in local communities. It may also add to the limited

information that exists on the mental health needs of Latino immigrants (Alegria et al.

2007).

Definitions

The following terms and constructs were utilized in the study. Each is

operationally defined according to the scholarly literature.

Acculturation. Acculturation occurs over a process of time where a group of

people integrates the social values, beliefs, and behavioral patterns of a different culture

with those from their culture of origin (VandenBos, 2004).

Acculturative stress. Acculturative stress occurs during the process of

acculturation and is identified by a reduction in health status not caused by other factors

(Berry, Kim, Minde, & Mok, 1987).

 15

Adolescence. Adolescence is a stage of human development that begins with the

onset of puberty and ends with physiological maturity (VandenBos, 2007).

Autonomy. Autonomy occurs when a person, group, or society gains

independence and self-determination (VandenBos, 2007).

Cohesion. Cohesion involves oneness or solidarity within a group where the

members experience a sense of belonging and are motivated to adhere to group standards

(VandenBos, 2007).

Collectivism. Collectivism is a cultural orientation where the needs and unity of

the group are emphasized over those of the individual (VandenBos, 2007).

Depression. Depression involves negative thoughts and a change in mood that can

range from sadness to despondency (VandenBos, 2007).

Depressed mood. Depressed mood includes depressive symptoms such as change

in affect, sleep, or appetite, but is not severe enough to warrant a clinical diagnosis of

Major Depression (Georgiades, Lewinsohn, Monroe, & Seeley, 2006).

Depressive disorder. Depressive disorder often involves sadness and is one of the

many mood disorders found in the DSM-IV-TR (American Psychiatric Association

[APA], 2000).

Dysphoria. Dysphoria involves a sad and discontent mood sometimes

accompanied by restlessness (VandenBos, 2007).

Familism/familismo. Familism is a value that occurs in collectivist cultures, with

expectations of close relationships, collaboration, and interdependence within the

extended family (VandenBos, 2007).

 16

Generation status. Generation status involves a person's nativity and the number

of generations that have lived in a particular culture. The first person of a family to be

born in a particular culture is considered first generation. When that person has children

they are considered second generation, and the numerical sequencing continues with each

subsequent generation living in that particular culture (Lee, Yoon, & Liu-Tom, 2006).

Latino. Latino is a term primarily used in the scholarly literature to identify people

in the United States whose heritage is from Spain and Latin America (Adams, 2004). It is

also the term used to identify males with this heritage (Rivera, 1994).

Latina. Latina is the term used to identify females of Latino heritage (Rivera,

1994).

Major depressive disorder. Also identified as Major Depression, this is a

depressive disorder that occurs when an individual experiences at least one major

depressive episode but has never experienced a manic or mixed episode (APA, 2000).

Major depressive episode. A characteristic of major depressive disorder, the

episode is a minimum of a two-week period where the person has either depressed mood

or anhedonia (VandenBos, 2007).

Personalismo. Common in Latino culture, personalismo is a social construct

where people build interpersonal relationships in a personal and caring manner

(Gonzales, Deardorff, Formoso, Barr, & Barrera, 2006).

Respeto. Respeto, also a common term in Latino culture, involves showing dignity

and respect to all people including parents and authority figures (Gonzales et al., 2006).
 17

Simpatico. Simpatico, another social construct common in Latino culture, looks to

avoid interpersonal conflict and create peace and harmony in relationships with others

(Gonzales et al., 2006).

Summary

Adolescent depression is a familial and societal problem that has been shown to relate to

numerous negative outcomes (Paradis et al., 2006). This is of particular concern in Latino

families, as Latino adolescents have the highest rates of depressive symptoms in the

United States. Studies on acculturation reveal that second generation Latino youth are at a

higher risk of depression than first generation Latinos (Pena et al., 2008). Given the

emphasis of family in Latino culture, it is possible that family cohesion acts as a buffer

against depression in adolescents. However, no studies to date have investigated the

relationship between family cohesion and depression in Latino adolescents.

This study conducted a secondary data analysis by utilizing a quantitative design

and a cross-sectional correlation research method. The study attempted to determine if

significant relationships exist among family cohesion, level of acculturation, gender, and

depression in Latino adolescents. Because girls experienced a higher rate of depression

than boys, the study attempted to determine if gender was a moderator variable between

adolescent reports of family cohesion and depression.

 18

CHAPTER 2: LITERATURE REVIEW

The purpose of this study was to determine if there was a significant relationship

among family cohesion, gender, level of acculturation, and depression in Latino

adolescents, and to determine if gender moderated the relationship between family

cohesion and depression. A quantitative research design utilizing a cross-sectional

descriptive correlational method and convenience sample were used in a secondary data

analysis. A search of the literature revealed that this research design is often used by

scholars studying these variables.

Introduction to Literature Review

The literature review is organized into separate sections, including the major

points of view from past and current research in related fields. Adolescence is defined as

a developmental stage of the human life cycle. Criteria for defining adolescent depression

is followed by the family protective factors and consequences associated with this mental

illness. Latino culture in the United States is explored as well as the role of family

cohesion to protect youth from depression. Next, the relationship among acculturation,

generation status, and depression is examined. The review concludes with an

understanding of the gender differences associated with depression, including the

different expectations for Latino adolescent males and females. This manner of

organizing the literature emerged from a disciplined search strategy.

The literature search strategy began with the careful selection of keywords and

phrases for database searches. These included depression, adolescence, family, cohesion,

Latino, Latino family values, acculturation, generation status, and gender. Once relevant

articles were found, the reference sections were carefully analyzed for additional articles.
 19

The strategy also included discussions with colleagues familiar with current

research being conducted by leading scholars in the field of adolescent depression. The

sources that were utilized to find peer-reviewed scholarly journal articles and books

included databases accessible through Northcentral University (NCU) and California

State University Northridge (CSUN). Databases utilized at NCU included EBSCOhost

(including PsycARTICLES and PsycINFO), ProQuest, and PsychiatryOnline. ERIC,

GenderWatch, JSTOR, PubMed, WorldCat, Wiley InterScience, and Dissertation

Abstracts were utilized at CSUN. Google Scholar was also helpful for locating

government publications.

The Adolescent

Adolescence is an essential developmental stage of the human life cycle that

identifies the passage from childhood to adulthood (Gilligan, 1997). This period involves

numerous physiological, psychological, and social changes, which often create stress for

this age (Martin & Fabes, 2009). The most notable physical change is the onset of

puberty, which includes the production of hormones in the reproductive system, rapid

gains in height and weight, development of secondary sex characteristics, and eventually

the capacity for reproduction (Gilligan). The changes during this stage involve numerous

adjustments.

Adolescent adjustment is influenced by numerous factors including the contextual

influences of culture, community, and family, as well as the adolescent's own subjective

perception of his or her family (Corona, Lefkowitz, Sigman, & Romo, 2005). According

to Eric Erikson (1950), the key psychosocial challenge of this stage involves the search

for identity. The adolescent's search for a sense of self-identity involves challenging
concerns such as the importance of belonging to a peer group, establishing career

aspirations, and connecting with what gives meaning to life (Erikson). Establishing this

identity requires autonomy.

Autonomy is an important construct in theories of adolescent development that

relates to the search for self-identity (Haase, Tomasik, & Silbereisen, 2008). Many of the

studies of autonomy utilize a longitudinal method. Van Ryzin, Gravely, and Roseth

(2009) explored the role of creating emotional distance from parents as the adolescent

develops self-reliance and independence. They must find a way to remain attached to

their parents and their peers yet function independently. Bray, Adams, Getz, and

McQueen (2003), using a convenience sample of over six thousand Hispanic, non-

Hispanic, and African American sixth through eighth grade adolescents, found that some

detach from their family too early, which results in excessive peer influence. Others do

not create sufficient independence from their family and fail to utilize the resources of

healthy peer interactions. Adolescents who successfully differentiate from parents

develop a strong sense of self-efficacy, which leads to successful individual and social

functioning.

Adolescent Depression

Due to the multiple cognitive, social-emotional, and physiological changes

occurring during this stage of development, adolescents are at an increased risk of

experiencing depression. Historically, the phenomenon of adolescent depression has been

described in different ways, beginning with the denial that depression occurred in

children, to the recognition that adolescents can and do experience depression similar to

adults, however some of the symptoms are reflective of their developmental stage (Speier
 21

et al., 1995). Today's scholars view adolescent depression on a continuum ranging from

mild to severe (Brengden, Wanner, Morin, & Vitarro, 2005; Costello, Swendsen, Rose, &

Dierker, 2008). Mild depression is often presented with few symptoms, such as dysphoric

mood and sadness, while more severe forms manifest in the psychiatric disorder Major

Depressive Disorder (APA, 2000).

Definition of clinical depression. According to the DSMIV-TR (APA, 2000),

depression is classified as a Mood Disorder with the predominant feature being a

disturbance in mood. Although the DSMIV-TR identifies several different types of mood

disorders with differing diagnostic criteria, including Major Depressive Disorder (MDD),

Dysthymic Disorder, Depressive Disorder Not Otherwise Specified, and Mood Disorder

Due to a General Medical Condition, disturbance in mood is the universal feature of

depression (APA). For the purpose of this research, Major Depressive Disorder and non-

diagnostic symptoms of depressed mood will be discussed. The other types of mood

disorders are beyond the scope of this paper.

Depressed mood and the associated riskfactors. It is important to note that

depressive symptoms and mood range on a continuum from mild to severe. Depressed

mood includes depressive symptoms such as unhappiness, sadness, dysphoria, sleep or

appetite disturbances, and is a known precursor to MDD. In the United States 20-50% of

adolescents have experienced symptoms of depressed mood at least once during this

stage of the life cycle (Malhotra & Das, 2007). Of all the symptoms that make up the

criteria for MDD, sad or depressed mood is a major predictor of MDD (Georgiades et al.,

2006). Although various authors in the scholarly literature use different names to identify

sub-clinical symptoms of depression (e.g., subthreshold, minor, and subsyndromal), most

 22

agree that depressed mood can lead to a major depressive episode, with significant

psychosocial risks in adolescence and adulthood (Brendgen et al., 2005; Costello et al.,

2008; Garber, 2006).

Diagnostic criteria for major depressive disorder (MDD). To be diagnosed with

MDD, an individual must have at least one episode of a major depressive episode,

without any previous manic, hypomanic or mixed episodes (APA, 2000). Diagnostic

criteria for a major depressive episode include:

A. Five (or more) of the following symptoms have been present during the same

2-week period and represent a change from previous functioning; at least one of the

symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not

include symptoms that are clearly due to a general medical condition, or mood-

incongruent delusions or hallucinations.

1. Depressed mood most of the day, nearly every day, as indicated by either

subjective report (e.g., feels sad or empty) or observation made by others (e.g.,

appears tearful). Note: In children and adolescents, can be irritable mood.

2. Markedly diminished interest or pleasure in all, or almost all, activities

most of the day, nearly every day (as indicated by either subjective account or

observation made by others).

3. Significant weight loss when not dieting or weight gain (e.g., a change of

more than 5% of body weight in a month), or decrease or increase in appetite

nearly every day. Note: In children, consider failure to make expected weight

gains.

4. Insomnia or hypersomnia nearly every day.

 23

5. Psychomotor agitation or retardation nearly every day (observable by

others, not merely subjective feelings of restlessness or being slowed down).

6. Fatigue or loss of energy nearly every day.

7. Feelings of worthlessness or excessive or inappropriate guilt (which may

be delusional) nearly every day (not merely self-reproach or guilt about being

sick).

8. Diminished ability to think or concentrate, or indecisiveness, nearly every

day (either by subjective account or as observed by others).

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal

ideation without a specific plan, or a suicide attempt or a specific plan for

committing suicide.

B. The symptoms do not meet criteria for a Mixed Episode.

C. The symptoms cause clinically significant distress or impairment in social,

occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance

(e.g., a drug of abuse, a medication) or a general medical condition (e.g.,

hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss

of a loved one, the symptoms persist for longer than 2 months or are characterized

by marked functional impairment, morbid preoccupation with worthlessness,

suicidal ideation, psychotic symptoms, or psychomotor retardation. (APA, 2000,

p. 356).
 In addition to exhibiting symptoms of the diagnostic criteria of a major depressive

episode, the predominant mood in adolescents can manifest as irritation or sadness. Other

symptoms can include a loss of interest in formerly pleasurable activities, complaints of

boredom, withdrawal from friends, somatic complaints and illnesses, a decline in

academic performance and social functioning, and acting out behaviors, such as running

away, truancy, or self-destructive acts (APA, 2000; American Academy of Child and

Adolescent Psychiatry, 2008a).

MDD in children and adolescents. The prevalence of MDD in preadolescent

children is low but rises in adolescence (Lewinsohn et al., 1998). This rise has increased

in the past few decades (Ryan, 2005), and has begun to occur at an earlier age (Son &

Kirchner, 2000). The frequency of MDD among the general population in middle and late

childhood (6-12 years) is about 1-2% and rises to 2-5% for adolescents (13-18 years)

(Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). Various studies have described a

pattern of increased depression in mid-adolescence (Cole et al., 2002; Garber, Keiley, &

Martin, 2002), followed by a decline in late adolescence and early adulthood (Costello et

al., 2008).

The consequences of adolescent depression. One of the main concerns of

depression in adolescence is its potential to reoccur throughout the life cycle. Therefore

many studies on the consequences of adolescent depression use a longitudinal method

and convenience samples. Few of these studies indicate a low continuity between

childhood and adult depression, as found in the studies by Stoolmiller, Kim and Capaldi

(2005), with a convenience sample of 206 boys and their parents from the Oregon Youth

Study, and Weissman et al., (1999) who surveyed 83 prepubescent children from the
Child and Adolescent Depression Clinic of New York State Psychiatric Institute. The

majority of findings indicate that depression during youth is an indicator of reoccurring

depression in adulthood (Bernal, Cumba-Aviles, & Saenz-Santiago, 2006; Pettit,

Lewinsohn, Roberts, Seeley, & Monteith, 2009). Studies with these results use a variety

of convenience samples: (a) the National Longitudinal Study of Adolescent Health

(Costello et al., 2008), (b) the Dutch general population (Van Lang, Ferdinand, &

Verhulst, 2007), and (c) children at high risk of depression (Williamson, Birmaher,

Axelson, Ryan, & Dahl, 2004). In the last decade, scholars have looked specifically at the

reoccurrence of depression and related disorders throughout adolescence and young

adulthood.

Various studies address depression in adolescents from ages 13-20. Hammen,

Brennan and Keenan-Miller (2008), using a convenience sample of 699 youth from a

birth cohort of over 7,000 women, found that many adolescents diagnosed with MDD

have a reoccurrence within the next few years. Using large convenience samples often in

excess of 1,500 subjects, many studies reveal that the risk factors of MDD in early

adulthood include having experienced it in childhood or adolescence, the number of

previous episodes, and how long the condition persisted (Klein, Shankman, Lewinsohn,

Rohde, & Seeley, 2004; Mondimore et al., 2006; Mondimore et al., 2007; Pettit et al.,

2009; Zisook et al., 2004). Half of the youth with a diagnosis of depression at age 15 are

also depressed at age 20 (Hammen et al.). Colman, Wadsworth, Croudace and Jones

(2007) used a convenience sample of 3,279 subjects from the ongoing 1946 British birth

cohort study to discover that children with major depression showed high rates of

depression throughout adulthood. Approximately 25% of those who experienced

 26

depression at either ages 13 or 15 had a mental disorder at ages 36,43, and 53, and 70%

of adolescents who experienced depression at both ages 13 and 15 had a mental disorder

at these ages.

There are many negative outcomes associated with depression. Le et al., (2003) in

a paper arguing that research for women should be a national priority, explain that

depression in childhood and adolescence is typically episodic and chronic. Gutman and

Sameroff (2004) used a longitudinal method while Hammen, Shih, and Brennan (2004)

used a cross-sectional correlation method. Each found that depression has many negative

outcomes including impaired social relationships and interpersonal dysfunction.

Longitudinal studies (Fergusson, Horwood, Ridder, & Beautrais, 2005; Haavisto

et al., 2004), the 2002 Annual Summary of Vital Statistics (Arias, MacDorman, Strobino,

& Guyer, 2003) and a review of studies examining the incidence of MDD (Cuijpers &

Smit, 2004), reveal that MDD in this age group has been linked to an increase in suicidal

ideation, attempted, and completed suicide—which is the third leading cause of death

among adolescents. According to the American Academy of Child and Adolescent

Psychiatry (2008b), annually thousands of adolescents commit suicide. It is the sixth

leading cause of death for those 5 to 14 years of age and the third leading cause of death

for those 15-24 years of age. It is understandable that Gilmer et al., (2005) using a cross-

sectional correlational method with a convenience sample of 1,380 subjects diagnosed

with MDD, found that adolescents who experience a chronic course of depression are at a

greater risk of impairment throughout adulthood. Due to these serious concerns, it is

important to understand the context of depression.

Family Factors and Adolescent Depression

Systems theory emphasizes the reciprocal and interdependent nature of family

relationships. It encompasses the bi-directional interconnectedness of each family

member and how changes in one part of the system influence changes in other parts of

the system (Minuchin, 2002). One of the ways that members of a system are affected is

through the amount of closeness, or cohesion, which exists among the members.

Family cohesion. Family cohesion, one of the dimensions of the Circumplex

Model (Olson & Gorall, 2003), and a component of family systems theory (Smith et al.,

2008) refers to the level of a family's emotional bonding and the degree of individual

autonomy among its members (Olson & Gorall). Family cohesion enhances the ability of

the family to work together through effective communication and problem solving skills

(Cuffe, McKeown, Addy, & Garrison, 2005). It is viewed as the way a family system

balances its members' needs for togetherness and individuality (Smith et al.). Utilizing a

cross-sectional descriptive correlational method and a convenience sample, Herman,

Ostrander, and Tucker (2007) investigated the relationship among family cohesion,

family conflict, and depression for African American and European American

adolescents. They concluded that low cohesion was associated with depression for the

African American, but not the European American adolescents. Level of cohesion can

therefore be viewed as a factor in depression.

Family risk and protective factors. The quality of relationships within a family

impacts adolescent development. Galambos, Leadbeater and Barker (2004), using a

convenience sample of 1,322 adolescents, found that the family is viewed as both a

protective factor and a risk factor of adolescent depression. Scholars have investigated
different aspects of family functioning that relate to family cohesion and their

relationship to protective and risk factors, such as social, parental, and family support and

conflict. In their longitudinal study, Galambos et al. (2004) indicated that social support

is one of many protective factors vital to healthy adolescent development. Therefore

understanding social support is important to the understanding of adolescent

development.

Social support has been defined as a sense of belonging to others, including

family members, and is related to higher adolescent functioning. Using a large

convenience sample of 11,835 adolescents from the National Longitudinal Study of

Adolescents Health, Cornwell (2003) found that supportive relationships protect the

adolescent from the negative effects that stress has on mental health, and in particular

provides a buffer for adolescents against depression (Galambos et al., 2004; Gutman &

Sameroff, 2004). Using a random sample of 1,083 potential high-school dropouts and

utilizing a cross-sectional correlational method, Randell, Wang, Herring, and Eggert

(2006) discovered the factors that were found to differentiate at-risk and not at-risk

adolescents for suicide included the family being available to discuss depression and/or

suicidal thoughts as well as the adolescent being satisfied with the family support they

received. One important form of social support is found in the parent/child relationship.

Children experience different qualities of parental support in the parent/child

dyad. In a meta-analysis of 45 studies on the relationship between parenting behaviors

and childhood depression, McLeod, Weisz and Wood (2007) found that numerous

aspects of parenting were related to depression. This was particularly so when the

behaviors included parental rejection (Magaro & Weisz, 2006). However, in studies
utilizing a longitudinal method, Meadows, Brown and Elder (2006) used a random

sample of over 20,000 high school students, and Stice, Ragan and Randall (2004) used a

convenience sample of 496 girls ages 11-15. Each found that parental support is a

protective factor against adolescent depression and is positively correlated to adolescent

mental health. Parental support in the form of a strong emotional bond with one or both

parents facilitates the adolescent feeling loved and supported (Cornwell, 2003). Using a

cross-sectional correlational method, Freeman and Brown (2001) indicated that

adolescents who have a secure attachment to their parents rate the support they receive

from them as more important than what they receive from their peers. Attachment is an

important component of parental support.

Establishing a secure attachment is one of the key principles of attachment theory.

Bowlby and Ainsworth (as cited in Bretherton, 1992) posit that a strong bond between a

child and mother (or other attachment figure) establishes a secure base. From this base

the child can freely explore their world. Erik Erikson (1997) also emphasizes the

importance of strong social relationships in child and adolescent development. He

asserted that mutual recognition and trustworthiness are essential during infancy and

become the building blocks for an adolescent's development of a sense of identity.

Unfortunately all children do not experience this secure attachment.

If a secure attachment does not occur or is disrupted through deprivation,

separation, or bereavement, it can be deleterious to healthy development (Bretherton,

1992). Erikson (1997) addressed the problems that can occur if the adolescent has poor

family and social relationships. The search for a positive identity en route to becoming a

contributing member of society requires strong familial and peer relationships. If these do
 30

not exist the adolescent, "may identify with outgroups to form a negative identity, or

remain confused by his or her sense of identity, a state Erikson calls identity diffusion"

(VandenBos, 2007, p. 464). Due to the problems that can occur with disrupted social

relationships, it is not surprising that Field, Diego, and Sanders (2001), using a

convenience sample and a cross-sectional correlational method, found that poor

attachment with parents is one of the most frequently studied risk factors for depression

during adolescence. In poor attachment relationships, adolescents rate the support from

their peers and romantic partners ahead of their parents (Freeman & Brown, 2001). The

level of attachment is therefore important to the well-being of the adolescent.

From this rationale, family support can be viewed as an aspect of family cohesion,

and thus is a protective factor against adolescent depression. In two studies, Corona et al.

(2005) used a cross-sectional correlational method and a snowballing sample of 111

Latina mother/adolescence dyads, and Cuffe et al., (2005) used a longitudinal method and

a convenience sample of 3,419 seventh through ninth grade students. Each found that

parent and adolescent conflict is detrimental to adolescent functioning. In particular,

studies in which the researchers utilized a cross-sectional correlational design (Burt et al.,

2005; Vandewater & Lansford, 2005) indicate that conflict between mothers and

adolescents is positively correlated with adolescent depression. Discord among the entire

family has been shown to be a factor related to adolescent depression (Cuffe et al.), and

increases the risk of suicide (Randell et al., 2006). From this theoretical perspective, it is

understandable how conflict undermines cohesion in the family system and is a risk

factor that contributes to adolescent depression. Another context to understand depression

is the adolescent's culture.

 31

Latino Culture and Families

Latinos are a heterogeneous mix of cultures, race, and ethnicity (Adams, 2004).

Cultural heritage is an important factor as Latinos leave their country of origin and begin

a new life in the United States. The diversity of the fastest growing minority group in the

United States and the changing ratio of first to second generation Latino Americans

provides the context of adolescent development in this country.

Latinos in the United States. The diversity among people of Spanish and Latin

American decent is rich and extensive. More than 20 nations make up Spanish speaking

Latin America. Commonalities are based on over 500 years of shared cultural influences.

Some of these include language, a history of colonization by Spain, and the Roman

Catholic Church's influence on values, ethics, and world-view (Adams, 2004). The

author emphasizes the differences that occur among Latino Americans are shaped by the

conditions of the country of origin that influenced the decision to emigrate. For example,

motivation to leave the historically war torn countries of Guatemala and El Salvador is

different from the primarily economic motives faced by rural Mexicans. This rich

diversity provides certain challenges for the researcher. It is important to understand the

qualities that affect all or nearly all Latinos and those that are unique to a country or

region.

Over the past 30 years, numerous names have been given to the people whose

origins span two continents, including North America, South America, and the country of

Spain. In 1980, the term Hispanic was the dominant label used to describe people of

Spanish-speaking heritage. Although Chicano was used in the late 1980s to describe
Americans of Mexican descent, Latino is the word most frequently found in the literature

today (Fontes, 2002). The journey of Latinos is dynamic and continues to be redefined.

Growth patterns and trajectories. Latinos are the largest and fastest growing

minority group in the United States (Halgunseth, 2004). At the time of the 2000 U.S.

census, Latinos had become the largest minority group in the country. They comprised

13% of the population, with a total of 35.3 million people (U.S. Bureau of the Census,

2008). Approximately half of the 11-14 million who immigrated to the United States

from 1990-2000 were Latino (Kaiser Commission on Medicaid and the Uninsured,

2004). The increase in immigration from countries such as Mexico (70%), El Salvador

(92%), Guatemala (125%), and Honduras (154%) has risen dramatically during this

decade (Logan, 2002). As of 2000, individuals born in Latin America represented 52.2%

of the total foreign-born population (U.S. Bureau of the Census, 2008). This growth is

predicted to continue throughout the 21 st century.

There has been a shift in the composition of Latinos in the United States (Logan,

2001). Recently, the fastest growth has not been from the large Hispanic groups of

Mexicans who were the first to arrive. Rather, the growth has occurred in what is referred

to in the literature as the New Latinos, those who have arrived from a diverse group of

Central American countries, such as El Salvador (Logan). It is anticipated that the rapid

increase of Latinos among the population in the United States will continue. Seventy

percent of Latinos are estimated to be younger than 40 years of age and are still of

childbearing age (U.S. Bureau of the Census, 2008). Demographers predict that with

current immigration and fertility rates, by 2025 nearly three in every 10 children in the

United States will have a Latino heritage (Fry & Passel, 2009) and by 2060, Latinos will
 33

comprise 25% of the United States population (U.S. Bureau of the Census). These

anticipated growth patterns will change the length of time that each extended family has

resided in the United States.

The ratio of first to second generation Latinos in the United States is predicted to

change (Suro & Passel, 2003). During 1970-2000, first generation Latinos (foreign born)

contributed to 45% of the growth of the Latino population and second generation (U.S.

born Latinos of immigrant parents) contributed to only 25%. During 2000-2020, it is

anticipated that the second generation will contribute to 47% of the growth, whereas the

first generation will contribute to only 28%. The number of second generation Latinos in

the United States is expected to surpass the first generation by 2020 (Suro & Passel).

These growth patterns will likely influence the values of the Latino family.

Latino family values. Latinos share numerous values that are generated from a

collectivist orientation (Halgunseth, 2004). Collectivism involves close family ties

through which the individual relies on the family to formulate a self-identity (Corona et

al., 2005) and develop a world view (Miranda, Bilot, Peluso, Berman, & Van Meek,

2006). Positive feelings depend on the sense of connection to others and fulfilling family

obligations. There are many values that emerge from collectivism, including making

sacrifices for the good of others: (a) sustaining harmonious relationships, (b) particularly

among family and close friends, (c) and the belief that membership in the group is the

key component of an individual's identity (Halgunseth). One of the key values of a

collectivist orientation is familism.

Traditional Latinos are expected to identify with familism or familismo (Gonzales

et al., 2006), which is the primary source of support in the culture (Zayas, Lester,
Cabassa, & Fortuna, 2005). This is characterized by high family loyalty and unity,

involvement with nuclear and extended family, prioritizing family and interpersonal

needs, support of and dependence on one another, and reliance on spiritual support

systems (Marin & Gamba, 2003; Miranda et al., 2006). The bonds that are established in

the Latino family ensure that these relationships will continue to be a strong source of

support and guidance when children enter adolescence. These bonds are essential

components of parenting when the adolescent's involvement with peers and activities

outside the home increases (German, Gonzales, & Dumka, 2009). European-American

concepts, such as emotional distance and independence, are highly incongruent with the

Latino value of familism, which is characterized by strong identification and attachment

to nuclear and extended family (Marin & Gamba, 2003). From this strong identification,

Latinos are encouraged to relate to others in specific ways.

Personalismo emphasizes interdependent relationships and relating to others in a

warm and personal way (Gonzales et al., 2006). Latinos are expected to deal with

problems by using personal relationships built over time, an approach that is incongruent

with Euro-American values, whose members put less emphasis on family and community

and more on individualism and efficiency (Adams, 2004). This Latino approach to

relationships is reinforced by simpatico, an emphasis on harmony in social relationships

and the avoidance of interpersonal conflict (Gonzales, et al.). These values greatly

influence Latino parent-adolescent interactions (Crean, 2008).

Respeto emphasizes respect and dignity toward others, in particular authority

figures such as parents (Gonzales et al., 2006). Studies utilizing a cross-sectional

correlational method compare families of different ethnic heritages. Using a convenience

 35

sample of 344 Mexican American and European American mother/child dyads, Hill,

Bush, and Roosa (2003) found that Latino families take a less child-centered approach to

everyday activities than Euro-American families. Baer, Prince, and Velez (2004), using a

convenience sample of over 6,000 Mexican American and European American middle

school students, and Fuligni, Tseng, and Lam (1999), using a convenience sample of

2,540 U.S. Latinos, each identified the Mexican value of respect for parental authority

and firm parent/child hierarchy, and noted that Mexican-American adolescents were less

likely to openly disagree and argue with their parents. Chapman and Perreira (2005), in

their presentation to the University of North Carolina School Work, emphasize that

respect and deference to parental authority are viewed as protective factors in Latino

families. Sustaining this level of respect toward parents strengthens the cohesion within

the family.

Family cohesion as a protective factor for Latino adolescents. Family cohesion is

often used as a proxy for familism in studies of Latino families (Baer & Schmitz, 2007).

Scholars conceptualize family cohesion as a global indicator of family support that is

positively related to family functioning during adolescence (Chapman & Perreira, 2005).

Baer (2002), utilized a convenience sample of 4,677 adolescents from the southwest

United States; and O'Donnell, O'Donnell, Wardlaw, and Stueve (2004), used a

convenience sample of 879 adolescents from middle schools in Brooklyn, New York:

each found cohesion to be a protective factor that provides a buffering effect against

stressful situations and leads to resiliency. The results of these studies reinforce the

importance of studying cohesion and familism.

 The protective value of family cohesion influences many areas of the adolescent's

life. Using a convenience sample of over 2,500 U.S. Latinos, Rivera et al. (2008) found

that an orientation towards, obligation to, and sense of family cohesion improves the

emotional health of Latino adolescents. Seeking social support from others, including

family members, is an effective coping mechanism for perceived stress in adolescents

Hill et al. (2003). Using a cross-sectional correlational method with a convenience

sample of 850 South Florida Latinos, Rivera (2007) found that perceived social support

from families is related to lower levels of psychological distress among Latino

adolescents. Hence, difficulties within the Latino family system that are a threat to

closeness or cohesion are detrimental to adolescents' functioning and relationship with

their parents (Corona et al., 2005; Herman et al., 2007). One of the potential outcomes is

the manifestation of depressive symptoms.

Depression in the Latino Adolescent

The expression of depressed mood is unique to each culture, as it is shaped and

molded by cultural norms (U.S. Department of Health and Human Services [DHHS],

2001). It is possible that because of the Latino adolescent's pursuit of harmonious

relationships with other family members, the family may discourage open discussion

about troubling thoughts and emotions. This is supported by research indicating that

Latinos often present psychological distress in terms of somatic complaints (Husain et al.,

2007).

Family cohesion, depression, and Latino adolescents. As noted above, the

traditional Latino family is a highly cohesive group, providing a protective factor for the

adolescent. Therefore, Latino families with low family cohesion put their adolescents at
risk for a variety of emotional and behavioral problems (Gonzales, Knight, Morgan-

Lopez, Saenz, and Sirolle, 2002; Corona et al., 2005). A number of studies, utilizing a

cross-sectional correlational method, have examined the relationship between family

cohesion and depression in Latino adolescents. Corona et al. (2005) showed that maternal

support of ethnic minority adolescents was related to lower levels of depressive

symptoms and a lower trajectory over time. Arbona and Power (2003) used a

convenience sample of 1,583 African, European, and Mexican American high school

students to discover that with Latino adolescents and their peers, those who reported a

close relationship with their parents had lower levels of depression and higher self-

esteem.

The study by Cespedes and Huey (2008) is of particular interest because their

sample comes from a Los Angeles high school, the same geographical area as this

proposed study. They surveyed 130 ninth through 12th grade Latino students. Their

multiple regression analysis revealed that low family cohesion was positively correlated

to depression as measured on the Reynold's Adolescent Depression Scale (as cited in

Cespedes & Huey, 2008). Additionally, in a convenience sample of 183 Mexican-origin

seventh and eighth grade girls and their mothers, Gonzales et al. (2006) found that

depression was significantly and negatively related to the level of attachment and

acceptance they perceived from their mothers. These studies substantiate the role of

cohesion as a protective factor against depression for Latino adolescents.

Depression in Latino adolescents. Although depression is prevalent among all

adolescent sub-cultures in the United States, researchers who examined the relationship

between ethnicity and depressive symptoms revealed that minority teens have higher
 38

depressive symptom levels than non-Hispanic Whites (Rushton, Forcier, and Schectman,

2002; Wight, Aneshensel, Botticello, and Sepulveda, 2005). In addition, when comparing

risk factors among Euro, Latino, African, and Asian American adolescents that

predispose them to depression, Latino American adolescents had the highest risk factors

(Gore & Aseltine, 2003; Umana-Taylor & Updegraff, 2007; Wight et al.). These findings

are particularly troublesome because of the many outcomes, in particular the potential for

suicide.

Suicide rates among Hispanic adolescents have increased dramatically in recent

years (Rutter & Begrebdt, 2004), and yet, ethnic minority adolescents are less likely to

get assessed accurately and are often not seen as an at-risk population (Rutter &

Begrebdt; Scouller & Smith, 2002). As noted in the section on adolescent depression,

there are many consequences associated with depressive symptoms in adolescence,

including chronic difficulties with psychosocial adjustment, an increased risk of recurrent

depressive episodes throughout adulthood, and an increased risk of attempted or

completed suicide (Pettit et al., 2009). Therefore, the research presented strongly suggests

that depression in Latino adolescents is of particular concern because this population

experiences more depressive symptoms than any other adolescent cultural subgroup in

the United States (U.S. Bureau of Census, 2008).

Acculturation, Generation Status, and Depression

Acculturation involves the process of leaving one culture and joining a new one

(Halgunseth, 2004). It creates psychological consequences for those who migrate and for

their descendents (Espin, 1999). There are many components associated with
 39

acculturation. Although many of them create stress, Latinos possess a resiliency

associated with this major life transition.

Acculturation. Caplan (2007) posits that acculturation consists of

multidimensional and complex social and psychological processes that occur at both

individual and family levels. The process of acquiring the cultural elements of the

dominant society (Lara, Gamboa, Kahramanian, Morales, & Bautista, 2005) involves

stressful changes (Caplan, 2007) that result from sustained contact with two or more

cultures (Gonzales et al., 2006). Furthermore, as noted by these researchers, as the family

becomes more integrated with the mainstream culture each generation adjusts by

changing their values and behaviors to fit the host culture. Therefore, understanding the

level of acculturation is important to understanding this process.

Generation status. Level of acculturation has been operationalized by using many

different indicators including generation status (Abe-Kim et al., 2007; Lee et al., 2006). A

person is considered first generation by coming to live in the host (new) country,

although born in the country of nativity. When that person has children in the new

country these children are considered second generation. The second generation usually

is more acculturated than the first generation because they have lived their entire life in

the new culture. Due to the stress associated with immigration, the first generation is

particularly vulnerable to acculturative stress.

Acculturative stress. Acculturative stress involves the emotional difficulties

immigrants experience as they adapt to their new environment (Chapman & Perreira,

2005). The stresses have a significant influence on psychological functioning (Miranda et

al., 2006) and may put an individual at risk for various problematic behaviors (Chapman
 40

& Perreira). Latin American families experience immigration stress when the values of

the original culture are challenged by those of the normative cultural mores of the United

States (Weisskirch & Alva, 2002). Latin American values of closeness, dependence, and

family loyalty (Fontes, 2002) often collide with those of the new highly individualistic

country (Miranda et al., 2006) with its emphasis on self, independence, appearance, and

material possessions (Hernandez, 2006). However, the values of the original culture often

help Latinos transition to their new home.

Crockett et al. (2007) has posited that Latino immigrants possess a resiliency in

response to immigration stress. Caplan (2007) concurs that although acculturation is

viewed as a major stressor, social networks and familism function as buffers or protective

factors to alleviate some of the stress. It is important to understand these buffering

resources as they can potentially protect the Latino adolescent from depression.

Acculturative stress and depression in Latino adolescents. Understanding the

stress that the acculturation process puts on Latino families is important because of its

effect on the developmental challenges of adolescence (Romero & Roberts, 2003), the

increased risk of depression (Chapman & Perreira, 2005), and overall deterioration of

mental health (Caplan, 2007). This is of particular concern when youth are experiencing

the challenges of adolescence while concurrently adjusting to a new culture (Chapman &

Perreira; Zayas et al., 2005). While the level of acculturation may be similar among all

members when the family first arrives, the adolescent often adapts more quickly than the

parents.

Families who immigrate to the United States do not have uniform levels of

acculturation among all family members. Children often learn and adapt to the new
 41

culture more rapidly than their parents (Lee et al., 2006). This can result in

intergenerational conflict, or acculturation gap, and disrupted relationships which have

been correlated with depressive symptoms in Mexican-origin youth (Gonzales et al.,

2006). In attempts to resolve the intergenerational conflict parents often try to transfer

protective Latino cultural beliefs to their children (Wagner et al., 2008). If the parents are

not able to sufficiently resolve the adolescent's abandonment of traditional Latino family

values, they may become frustrated and embarrassed. This often results in increased

parent/child conflict (Portes & Zady, 2002), putting the adolescent at risk of depression

and suicidal ideation (Alegria et al., 2007).

Most of the literature is consistent in the findings of the relationship between level

of acculturation and adolescent depression. More acculturated adolescents experience

greater mental health symptoms than their less acculturated counterparts (Gonzales et al.,

2006) leading scholars to conclude that high levels of involvement in traditional Latino

family values serve as a protective factor against depression (Umana-Taylor &

Updegraff, 2007). These conclusions are understandable given the level of care and

respect modeled and experienced within the Latino family. However, this pattern of

increased level of acculturation and increased mental health symptoms does not apply to

all Latino adolescents.

There is an emerging body of literature that reveals decreased levels of depression

as Latinos acculturate into the mainstream culture. Torres and Rollock (2007), using a

cross-sectional correlational method with a convenience sample of 96 Hispanic adults

from a moderately sized Midwestern city, found that intercultural competence moderates

the relationship between acculturation and depression in Latino adults. They concluded
 42

that an active problem-solving style resulted in fewer symptoms of depression and that

"competence-based approaches to cultural adaptation provide a description of the

functional skills associated with adjustment and introduce adaptive personal attributes

within a cultural context" (Torres & Rollock, p. 15). This new trend challenges scholars

to look comprehensively at all the factors that are related to acculturation and depression.

Generation status and acculturative stress. Acculturation gaps are the differences

in acculturation levels between parents and children (Martinez, 2006). Miranda et al.

(2006), in an article that defines acculturation and its evolution from a one-dimensional to

a multidimensional construct, reveal that acculturation has been shown to increase family

stress. Lee and Liu (2001), using a cross-sectional correlational method and a

convenience sample of 406 Asian, Hispanic, and European American college students,

found that the cultural differences between parents and adolescents can accentuate

intergenerational conflict, which can result in widespread family conflict. Therefore, it is

important to look at generation status.

First generation status immigrants experience the highest level of acculturative

stress (Garcia, 2007). Utilizing a cross-sectional correlational method and a convenience

sample of 209 Mexican American adults, the author found acculturative stress to be

related to depressive symptoms and suicidal ideation. Utilizing a longitudinal method and

a convenience sample of 20,745 adolescents from three waves of the National

Longitudinal Study of Adolescent Health, Brown, Meadows and Elder (2007) found that

generation status has a significant effect on trajectories of depression symptoms of Latino

adolescents. These trajectories are also related to suicide.

 43

Two very different studies show that the relationship between generation status

and acculturative stress is also related to suicide attempts. Pefia et al. (2008) used a cross-

sectional correlational method and a convenience samplefromthe National Longitudinal

Study of Adolescent Health, and Singh and Hiatt (2006) used a longitudinal method and a

convenience sample from 1993 and 2003 National Health Interview Surveys. Each found

that first generation adolescents are less likely to attempt suicide than second and third

generation adolescents, and that second generation Latinos are almost three times more

likely than the first generation to attempt suicide. These findings reveal that protective

factors of traditional Latino values are still in place in first generation immigrant families

and diminish with each generation.

Gender and Depression

Gender is the term that researchers use to identify whether a subject is male or

female. Across all ethnicities, the APA (2000) indicates that females experience more

depressive symptoms than males. Roza, Hofstr, Van der Ende, and Verhulst (2003),

utilizing a longitudinal method and a random sample of 2,600 children and adolescents,

found that the sex ratio for depression among pre-pubescent children is approximately

equal for boys and girls. At age 13, the ratio remains similar (Corona et al., 2005), but

during the remainder of adolescence it dramatically changes.

The developmental trajectories of adolescent depression are different in males and

females. Li, DiGiuseppe, and Froh (2006) used a cross-sectional correlational method and

a convenience sample of 246 adolescent males and females to discover that during

middle and late adolescence twice as many females experience depression than males.

Their findings are consistent with the review of the literature by Hazier and Mellin
 44

(2004). Male adolescents have increased depressive symptoms in early adolescence

followed by a decreasing trajectory through mid and late adolescence. The trajectory of

depression in females increases in late childhood and continues to do so until late

adolescence. For both genders, depressive symptoms reach the highest level in mid-

adolescence (Dekker et al., 2007). The reasons vary as to why these different patterns

occur.

Explanation ofgender differences and depression. Scholars have offered several

reasons for gender differences in depressive trends: (a) the internalization and

externalization of depressive emotions (Bailey, Zauszniewski, & Hemstrom-Kxainess,

2007), (b) gender differences in coping styles (Bhatia & Bhatia, 2006; Nolen-Hoeksema,

2001), and (c) the gender-specific ways adolescents react to negative life circumstances

(Hankin, Mermelstein, & Roesch, 2007). Longitudinal studies using convenience samples

of 14-19 year-old (Galaif, Sussman, Chou, & Wills, 2003) and 13-18 year-old (Hankin et

al.) adolescents reveal that females are more likely than males to react to stressors with

depressive symptoms. They also place a greater importance on interpersonal relationships

so they tend to experience depressive reactions in response to relationship difficulties.

These findings were duplicated in other studies, as in the one by Shih, Eberhart,

Hammen, and Brennan (2006), who used a cross-sectional correlational method and a

convenience sample of 15-year old adolescents, and in the literature review by Hankin et

al. Alternatively Gutman and Sameroff (2004), using a longitudinal method and a

convenience sample of 372 families, found that males are more susceptible to depressive

symptoms by internalizing their emotions in response to family challenges. However, not

all scholars support these reasons for the gender differences in depressive trends.
 According to Enns (2000), many feminist scholars and practitioners believe that

the DSM, the standard used to diagnose depression, is male-biased, pathologizes the

experience of women, and supports their subordination. Feminist psychologists and

therapists routinely address the issue of gender bias in diagnosis and assessment. They

believe that many therapists do not accurately diagnose because of their own

stereotypical gender beliefs. Succumbing to gender bias inherent in psychometric

instruments, they fail to adequately consider the contextual factors that influence

behaviors. As a result, different psychological labels are applied to men and women who

exhibit similar behaviors (Enns, 2000).

Internalized behaviors and mood disorders have been studied extensively by

feminist scholars and their findings provide an understanding about depressive outcomes

for males and females. Chodorow (1989) addresses the role of socialization on gender

and identity development. She believes that mothers have a closer bond with their infant

daughters than their infant sons. As a result, girls are socialized to be more comfortable

with intimacy. To form their identities, boys are expected to separate from their mothers

while girls are not required to do so. Chodorow believes that the devalued role of women

in society results from the psychologically difficult process men must undertake to

separate from the feminine role. She describes that while women develop their sense of

self in relationship with their mothers, men develop selves that deny intimate relationship

with others.

Building on the influence of socialization, Bern's (1993) contribution to gender

schema theory addresses the role of cognitive organization. Individual gender formation,

according to this theory, builds on two foundational presuppositions. The first is that the
developing child internalizes gender lenses found within the social practices of their

culture. Second, the internalized lenses predispose the child throughout the lifecycle to

construct a gender identity consistent with these childhood messages (Bern, 1993). The

internalized schemes become self-perpetuated and can contribute to depression.

An understanding of the well-established gender schemes that exist within

individuals helps explain how perpetuation of subordination leaves women vulnerable to

depression. Gilligan (1982) addresses the issue of male and female power in society and

believes that male domination is sustained through a hierarchical structure. This hierarchy

is very different from female connectedness, which Gilligan refers to as a web. When this

web is broken, as occurs through immigration to a new culture, women become isolated

and more vulnerable to depression. Gilligan's conceptualization of the web is particularly

relevant to Latino adolescents.

Gender and depression in Latino andLatina adolescents. Similar to the general

population, the literature indicates that Latina females manifest symptoms of clinical

depression at a higher rate than Latino males (Barrera, 2006; Hernandez, 2006). Latina

female gender is related to greater psychological distress and is a risk factor for

depressive symptoms (Chapman & Perreira, 2005). The rates of attempted suicides, an

indicator of depression, are higher among Latina adolescents than any other adolescent

population (Zayas et al., 2005). The Centers for Disease Control and Prevention (2006)

found that Latinas age 14-18 are more likely to experience depression (47%) than their

African American (37%) and European American (33%) female peers. They also found

that Latino boys of the same age are more likely to experience depression (26%) than

their African American (20%) and European American (18%) male peers (Eaton et al.,
2006). Zayas et al. also found that the rate of attempted suicide, an indicator of

depression, was higher among Latina adolescents than those from other American

subcultures. Understanding these different rates requires a further understanding of the

Latino family.

Expectations for males andfemales in Latino families. The gender discrepancies

for depression may be explained by the different gender expectations in the Latino

family. Gender differences exist in the cultural socialization process of Latino males and

Latina females (Azmitia & Brown, 2002; Raffaelli & Ontai, 2004), and gender is an

organizing feature of family responsibilities and roles (Cauce & Domenech-Rodriguez,

2002). Latina females are socialized to be passive, demure, and hyper-responsible for

family obligations, unity, and harmony (Zayas et al., 2005). Compared to sons, daughters

are generally required to help out more inside the home and tend to experience greater

supervision, which results in behavioral restrictions. Females are often expected to

participate more in family obligations, while males are extended greater autonomy

outside the home (Umafia-Taylor & Updegraff, 2007). Latina women are expected to be

honorable and dedicated. These traits and qualities are reinforced by marianismo, a

cultural norm that originates from admiration of the Virgin Mary and the expectation to

emulate her virtues (Miranda et al., 2006). Gender discrepancies of depression may also

be explained by cultural expectations.

The challenges faced by Latinas in the United States are further complicated by

the experience of, and/or the familial history of, cultural dislocation. Many come from

traditional cultures where historically there has been minimal social change for decades

(Espin, 1999). Consequently, the deeply ingrained gender roles of women are profoundly
challenged as they immigrate to the United States. Espin believes that it is often more

difficult for women than men to learn what is appropriate behavior in the new culture.

Because their identity is still developing, it may be easier for Latina adolescents than

older women to adjust to a new culture. However, there also are additional burdens to the

adolescent due to the loss of peer support that would have helped to shape their identity

in their native culture (Espin).

Espin (1999) emphasizes the point that when women migrate across physical

borders it provides the opportunity to cross boundaries and experiment with new gender

roles, including expression of sexuality. For many women the opportunities afforded to

them create possibilities that are liberating. However, because of the deep cultural and

familial norms that emphasize traditional values, there often is an internal struggle. Her

sexual behaviors and conformity to traditional gender roles serve a political role in

society because they are the markers of the value system within a family (Espin, 1999).

Therefore, a woman who experiments with new sexual roles and behaviors soon learns

that the guardians of morality and tradition have great power in the immigrant

community. In contrast, the experience of Latino males is very different.

Latino males are expected to exercise control over decisions that affect the family,

including their children and wife or partner. They are expected to be powerful, and

ideally this level of power is used to care for the well-being and needs of the family

(Miranda et al., 2006). Furthermore, these traits and qualities are reinforced by

machismo, a cultural norm that has been defined as a strong sense of masculinity that

manifests as courage, strength, aggressiveness, and domination of women. These traits

are deeply ingrained and often manifest within the United States. Therefore, it is
understandable that as Latino males redefine their roles as U.S. males their expenence is

very different than Latinas.

Gender as a potential moderator variable. As previously identified, distinct

differences exist in the socialization of adolescent males and females in Latino families.

As a result, it is possible that gender moderates the relationship between other variables.

A moderator variable systematically modifies the strength of the relationship between

other variables within a study (Sharma, Durand, & Gur-Arie, 1981). Therefore it is

important to determine if gender modifies the strength of the relationships among

cohesion, level of acculturation, and depression.

Various longitudinal and correlational studies involving an adolescent sample

have examined the role of gender as a moderator variable. However, no studies to date

have examined if gender moderates the relationship among family cohesion, level of

acculturation, and depression in adolescent Latinos. Regarding studies found by this

author, the majority reveal that gender did function in a way that moderated relationships

between the other variables.

The following articles are representative of studies where gender was found to be

a moderator variable. In a longitudinal study using a convenience sample of 186 seventh-

grade students, Dao et al. (2006) found that for girls but not boys, gender moderated the

effects of past experience(s) of victimization on nonspecific psychological distress. In

three studies utilizing a correlational method, gender was also found to moderate the

other variables. Using a convenience sample of 202 college students, Bekker, Bachrach,

and Croon (2007) found that gender moderated the relationship between the two

independent variables (anxious attachment and avoidant attachment) and the two
 50

dependent variables (antisocial behavior and passive-aggressive behavior). Cohn and

Modecki (2007), using a convenience sampling of over 800 high school students, found

that gender moderated the relationship among the belief that the world is just,

authoritarianism, attitudes toward the criminal legal system, and delinquent behavior.

With a convenience sample of 272 college students, Lanthier and Windham (2004) found

that gender moderated the effect of using the Internet for social use and institutional

attachment, academic adjustment, and total adjustment. Fewer studies on adolescents

reveal that gender was not a moderator variable.

In study using a convenience sample of over 3,000 college students, Nurmi,

Aunola, Salmela-Aro, and Lindroos (2003) gender was not shown to be a moderator

variable. They found that gender did not moderate the relationship among academic

beliefs and strategies, causal attributions, and academic achievement. These articles

described above, regardless of whether gender was found to moderate the other variables

of the study, reveal an important trend. When gender is used as a variable in a study, it is

common for scholars to run a regression analysis to determine if it also functions as a

moderator. Because the majority of the articles reviewed indicate that gender does

function in this way, it was important to include it in the study.

Summary

Adolescence is a unique developmental stage in the life cycle involving multiple

physiological, cognitive, and social emotional changes (Martin & Fabes, 2009). These

challenges leave the adolescent vulnerable to risk factors and poor outcomes, including

depressive symptoms, major depressive disorder, attempted suicide, and the risk of

ongoing psychosocial and mental health consequences throughout adulthood (Pettit et al.,
 51

2009). Family cohesion serves as a protective factor for adolescent depression (Herman

et al., 2007) and traditional Latino family values naturally characterize cohesion (Baer &

Schmitz, 2007). Latino immigrant adolescents are at a particular risk for depression with

a higher depression rate than any other ethnic group of adolescents in the United States

(SAMHSA, 2008). Research indicates that this is a result of greater acculturation, placing

second-generation Latino adolescents at a higher risk for depression (Pena et al., 2008).

Gender is also a predictor of depression and female Latina adolescents experience the

highest levels of depression among their adolescent peers (Barrera, 2006). Depression

clearly involved numerous psychosocial components that create challenges for Latino

adolescents in the future.

It is projected that Latinos, the largest minority in the United States, will comprise

25% of the population by the year 2060 (U.S. Bureau of the Census, 2008). Due to the

many factors stated above and the current lack of research investigating the relationship

among family cohesion, gender, level of acculturation, and depression in adolescent

Latinos, there was a need for this study. Like most studies on this topic, a qualitative

design utilizing a cross-sectional correlational method and a convenience sample was

used. The results of this study will provide the impetus for increased awareness and

proactive changes among policy makers, helping professionals, and all of those who

interact with this at risk population.

 52

CHAPTER 3: RESEARCH METHOD

The problem of adolescent depression is of concern because it has been shown to

relate to numerous negative outcomes, including increased risk of depression in

adulthood (Lewinsohn, et al., 1999), difficulty with psychosocial adjustment, substance

abuse, as well as suicidal ideation and attempts (Paradis et al., 2006). Latino adolescents

have the highest rates of depressive symptoms of all cultural groups in the United States.

Female Latino adolescents have a higher rate of depressive symptoms than their male

counterparts (SAMHSA, 2008).

Acculturative stress occurs during the process of immigrating from one culture to

another and has been shown to correlate with depression. However, in Latino

adolescents, depression has been shown to be higher in the second generation than the

first (Pena et al., 2008). The research suggests that Latino adolescents who live in

families with a higher level of acculturation are more likely to experience depression than

those who live in families with lower levels of acculturation. The importance of family in

Latino culture increases the possibility that loss of family cohesion might be a predictor

of depression. The correlation between family cohesion and depression has been studied

in Caucasian families, yet it is relatively unknown in Latino families (Clark et al., 2007;

Kelch-Oliver, Smith, Diaz, & Collins, 2007; Vazsonyi & Belliston, 2006).

In addition, it is uncertain if the gender of the Latino adolescent acts to moderate

the relationship between reports of family cohesion and the effect on depression. It

appears that no studies to date have examined the variables in the relationship among

family cohesion, gender, level of acculturation, and depression in Latino adolescents, and

whether the adolescent's gender is a moderating variable.

 53

The purpose of the study was to determine if there was a significant relationship

among family cohesion, gender, level of acculturation, and depression in the Latino

adolescent, and to determine if gender moderated the relationship between family

cohesion and depression. Utilizing a quantitative research design, a cross-sectional

descriptive correlational method was used in a secondary data analysis. The study was

designed to determine if Latina female adolescents experience a higher rate of depressive

symptoms than their male counterparts.

The following research questions guided this study.

Ql: What is the relationship between family cohesion and depression among

Latino adolescents?

Q2: What is the relationship between gender and depression among Latino

adolescents?

Q3: Does the gender of the Latino adolescent moderate the relationship between

their reports of family cohesion and its effect on depression?

Q4: What is the relationship between level of acculturation and depression among

Latino adolescents?

The third question was of particular importance to the first two because, if

established as a moderator variable, it could influence the direction and/or strength of the

variables. For this research, if gender moderated the relationship between family

cohesion and adolescent depression, then it would have been expected that the

relationship between them would be different for boys and girls.

It was hypothesized that the following would result from the study.
 Hla: There is a relationship between family cohesion and depression among

Latino adolescents.

H2a: There is a relationship between gender and depression among Latino

adolescents. Females are more likely than males to develop symptoms of depression.

H3a: The gender of the adolescent will moderate the relationship between their

reports of family cohesion and depression.

H4a: There is a relationship between level of acculturation and depression among

Latino adolescents. Latino adolescents who live in a family with a higher level of

acculturation are more likely to experience depression than those who live in a family

with a lower level of acculturation.

In this chapter, the research method and design for the study are described.

Selection of the population and the number of participants are justified through a power

analysis. The materials and published instruments utilized to measure each construct are

explained. The chapter also includes the required procedures to replicate the study. Types

of data collected by the original investigators are described in addition to an explanation

and justification of each statistical method for this study. Methodological assumptions,

limitations to the study, and delimitations are explained. Although the study did not

involve direct contact with participants or access to any identifying information, ethical

assurances are addressed at the end of this chapter.

Research Method and Design

A quantitative design and a cross-sectional descriptive correlational method were

selected for this study. This design is used most often by scholars in their systematic

scientific investigation of the quantitative property of depression and its relationship to

 55

other variables. Most researchers examining the variables of this study utilize a cross-

sectional descriptive method; some use a longitudinal method. Very few true

experimental studies with random or probability samples have been conducted on these

variables, and those that have involve various forms of treatment of depression.

As indicated earlier, an existing dataset from the Latino Adolescent Development

research project of California State University Northridge (CSUN) was analyzed. This

design and method were utilized to determine if the predicted relationships existed in the

four hypotheses stated above. Because they did, the strength of relationship between

depression and each of the other variables was determined. Determining the relationship

of H3 was of particular importance to the relationships of Hi and H2 because, if it had

been established as a moderator variable, it could have influenced the direction and/or

strength of the variables. If gender moderated the relationship between family cohesion

and adolescent depression, then it would have been expected that the relationship

between them would be different for males and females.

Zero-order correlations (i.e., Pearson's correlations) were used to examine the

bivariate relationships between generation status of the adolescent, gender of the

adolescent, family cohesion, and depressed mood. Pearson's correlation coefficients were

used to determine if there was a positive or negative relationship between two variables

that were continuous in nature. A hierarchical multiple regression analysis was conducted

to analyze the collected data. The first step was to determine the main effects of the three

independent variables. The researcher attempted to explain how much variance family

cohesion, gender, and level of acculturation accounted for depression. The direction of

each variable on depression was determined. The second step of the regression analysis
was to determine the interactive effects of these variables. The researcher attempted to

explain if gender was a moderator variable of family cohesion and depression influencing

the direction and strength of each variable.

Participants

The principal investigators of the Latino Adolescent Development research

project of CSUN were granted permission from a greater Los Angeles multi-track, year-

round high school to collect quantitative data in the spring and summer sessions of the

2005-2006 academic year. They chose to use a non-probability convenience sampling

method from the predominantly Latino student body population. The specific ethnic

breakdown included 89% Latino American, 3% Filipino American, 3% Caucasian

American, 2% African American, and 2% Asian American (California Department of

Education, 2005).

One of the principal investigators of the Latino Adolescent Development research

project worked with the school counselor to obtain permission from the school

administration. The Latino Adolescent Development team then met with teachers to

explain the research project. These educators were given parental consent forms and a

letter explaining the research project. Students were expected to take the letter and forms

home and have the consent forms signed by one of their parents or their legal guardian.

Parents were expected to indicate whether they did or did not consent to their child

participating in the research. Students were instructed to return the signed forms to their

teachers. Only those students whose parent/legal guardian gave permission were allowed

to participate in the study.

 57

The Latino Adolescent Development researchers distributed adolescent consent

forms to those students whose parents had given permission. After the students signed the

forms, data were collected using self-report surveys, which included detailed instructions

for completion. Upon completion of the surveys, the students were given an explanation

of the research project and were encouraged to ask questions.

There were 659 high school students who participated in the Latino Adolescent

Development research project. From the 659,400 students were identified as Latino.

From this «=400,99.2 % (« =397) were in ninth grade and 0.8 % (n =3) were in 10th. The

ages of the students were 45.7 % (n =182) 14 years of age, 50.8 % (« =202) were 15, and

3.5 % (n =14) were 16 (2 missing). Gender distribution included 53.5 % (n =214) female

and 46.5% (n =186) male. Generation status included 15.4 % (n =61) first generation

American, 82.1 % (n =326) second, and 2.5 % (n =10) third (3 missing).

To determine if a sample size of 400 was large enough to conduct the secondary

analysis, a power analysis was computed. To do so, an online Java applet developed by

Lenth (2006) was used. The data analysis was a multiple linear regression equation with

four predictors (family cohesion, gender, generation status, and family cohesion X gender

interaction) with a sample size of 400 Latino adolescents. With four predictors, an alpha

of .05, beta of .20, two-tailed analysis, and sample size of 400, Lenth's (2006) Java applet

indicated a power equal to .9788 for the analysis.

G*Power 3 software (Faul, Erdfelder, Lang, & Buchner, 2007), was used to

compute power. An a priori power analysis was conducted for multiple regression

analysis with four predictor variables. According to the software, to attain a power of .80
with four predictor variables, a total sample size of 85 is required. To attain a power of

.95 a total sample size of 129 is required.

One additional method was used to ensure sufficient power using multiple

regression analyses. Tabachnick and Fidell (2001) have recommended that for acceptable

power the minimum number of participants should be equal to 50 plus eight times the

number of independent variables. Therefore, for this researcher's dissertation, 50 + (8 X

4) = 82 participants were needed. Since each method utilizes a different mathematical

approach to calculate their power analysis, different numbers were attained. According to

the estimates by Faul et al. (2007) and Tabachnick and Fidell, the minimum number of

participants required for this study is 129. The number of participants in the existing data

set was 400. Since this exceeded the minimum number of subjects needed to ensure

sufficient power based on all three estimates, and there was no additional cost or time

involved in analyzing the entire data set, all 400 participants were used in the study.

Materials/Instruments

A demographic survey was administered that included items to identify age,

gender, grade, who lives in the home, language spoken in the home, ethnic group,

generation status, wealth of families in neighborhood, and others (Appendix A). Gender

and level of acculturation are variables that do not require instrumentation to measure.

Gender was identified on a nominal scale by asking the adolescents "What is your

gender?" (0 = Female, 1 = Male). Level of acculturation was measured by assessing

generation status. Adolescents were asked what country they were born in and what

country their mother and father were born in. The coding was identified as follows: 1 =

first generation included those youth who were foreign born and had foreign born
 59

parents, 2 = second generation included those youth who were born in the U.S. but had

one (or both) foreign-born parents, and 3 = third generation included those youth and

parents who were born in the U.S.

Generation status is often used as a proxy for level of acculturation. One argument

for using validated instruments on acculturation instead of generation status is that it does

not adequately indicate the person's level of adoption of host culture's values and

behaviors (Lee & Liu, 2001). However, many of the demographic, social, and economic

characteristics of Latino children vary greatly by their generation status (Fry & Passel,

2009). Generation status can be viewed as an indicator of level of acculturation by

measuring the level of acculturative stress. In Latinos, acculturative stress has been

shown to be related to psychological stress (Finch, Kolody, & Vega, 2000), mental health

problems including anger, feelings of loss, guilt, depression, and alcoholism as well as

relational and family problems (Smart & Smart, 1995). First generation adolescents

probably experience more acculturative stress than second because they and their family

are all adjusting to an entirely new culture. Therefore it is understandable that scholars

use generation status as a proxy for level of acculturation (Plunkett & Bamaca-Gomez,

2003).

To assess family cohesion, the Latino Adolescent Development researchers used

a nine-item modification of the Cohesion subscale of the FES created by Moos and Moos

(1994). To assess depression, they used Radloff s (1977) 20-item CES-D for depressed

mood. A brief description of each instrument including published background

information is described below. The actual questions of each instrument are provided in

Appendix B and Appendix C.

 Family cohesion. The FES was created by Bernice Moos and Rudolf Moos in

1974 (as cited in Mindgarden, n.d.). Currently in its fourth edition, the FES was

developed to measure the social climate of all types of families. It has been widely used

in clinical and research applications. Over 1,750 studies have used the instrument since

its inception (Mindgarden). The scale is based on three family dimensions: (a)

relationship, (b) personal growth, and (c) system maintenance (Nova Southeastern

University [NSE], n.d.). Each dimension has numerous subscales, which can be

administered as a separate entity or as part of the entire instrument. Three different forms

of the scale are available that measure family members' perception. The Real Form

assesses how members currently view their families, the Ideal Form measures members'

ideal family environment, and the Expectations Form challenges members to determine

what they would expect a family environment to look like under certain changed

conditions (NSE, n.d.).

The FES (Appendix A) is comprised of 90 items that are grouped into 10

subscales (Mindgarden, n.d). The combination of scores on all of the subscales creates an

overall profile of the family environment (NSE, n.d.). Cohesion is a subscale of the

Relationship category. The entire scale is easy to administer, can be completed in 20

minutes, is designed for people with a sixth-grade reading level, and can be used for ages

11 through adult (Mindgarden).

Depression. The 20-item CES-D was developed in 1977 by researchers at the

Center for Epidemiologic Studies at the National Institute of Mental Health to measure

depressive symptoms among adults in community surveys (Roberts, Andrews,

Lewinsohn, & Hops, 1990). Lenore Radloff (1977), the scale's principal author, stated in
 61

her article that its intended use is different from previous depression scales that are used

mainly for diagnosis at a clinical intake. The CES-D was designed to measure current

level of the affective component of depressive symptomatology. Unlike measures

constructed for clinical purposes, it was designed for use in general population surveys.

In particular, it was designed for research of the relationship between depression and

other variables. With only 20 items, its administration is simple for the subject and

research assistants (Radloff).

The 20 questions (Appendix B) identify numerous psychological and physical

symptoms of depression. These can be grouped in the following categories: (a) Somatic-

Retarded Activity, (b) Depressed Affect, (c) Positive Affect, and (d) Interpersonal

Relations (Radloff, 1977). Okun, Stein, Bauman, and Silver (1996) compared the CES-D

item content with diagnostic criterion and symptoms of Major Depressive Episode in the

DSMIV-TR (APA, 2000). The CES-D items correlated with seven of the nine criterion-

based symptoms of Major Depressive Episode, yielding the researchers' support of the

instrument's applicability for current research (Okun et al.).

Although originally designed to measure levels of depressive symptomatology in

adults, it has been commonly used with adolescents (Garrison, Addy, Jackson,

McKeown, & Waller, 1992; Motl, Dishman, Birnbaum, & Lytle, 2005). Motl et al.

explained that using the instrument with this population is appropriate because the basic

diagnostic symptoms of depression are similar for adults and adolescents. In an attempt to

support the appropriateness of its use among adolescents, Radloff (1991) administered

the CES-D to high school and college students. The results of this study were compared

to existing data from junior high students, patients with depression, and a community
sample of young adults. Her conclusion was that the results of the analyses suggest the

instrument is acceptable for use with all of the groups studied (Radloff).

FES. Moos and Moos (1994) reported acceptable reliability estimates with

Cronbach's alphas = .86 to .72. Nova Southeastern University (n.d.) stated that Moos and

Moos reported intercorrelations of the 10 subscales ranging from -.53 to .45, suggesting

that the scales measure different characteristics with adequate consistency. Test-retest

reliabilities for two-, three-, and twelve-month intervals ranged from .52 to .91,

suggesting stability across each time interval (NSE, n.d.).

Face validity is supported by well-written statements about occurrences in

families which clearly relate to the specific subscales. Validity is also substantiated in the

user's manual through references to approximately 150 additional research studies (NSE,

n.d.). Boyd, Gullone, Needleman, and Burt (1997) stated that doubts have been raised

about the scale's reliability. In particular, Roosa and Beals (1990) found that five of the

subscales were not only lower than those reported in the manual (Moos & Moos, 1986),

but were below the accepted level for research purposes (Tabachnick & Fidell, 2001).

Boyd et al. found in their study of a large group (1,289) of adolescents that reliability for

six of the 10 subscales was low. Fortunately for this researcher, the Cohesion subscale

was one of the four that was found to have an acceptable level of reliability (0.67).

CES-D. Radloff (1977) reported that the CES-D was found to have very high

internal consistency and adequate test-retest reliability. Cronbach's alpha ranged from

.84 to .90 for various subgroups within n of 5,066. Split halves ranged from .77 to .85,

and the Spearman-Brown ranged from .87 to .92 (Radloff).

 63

Test-retest predictions were influenced by different factors. Because the CES-D

was designed to measure current level of symptomatology, it was anticipated that test-

retest correlations would decrease over time. The overall response correlations were

moderate, ranging from .45 to .70. Those who had experienced one of 14 negative life

events prior to the first or second testing had lower correlations than those who did not

(.54). The retest range was from two weeks to one year, with the short period having the

highest correlation and the long period having the lowest (Radloff, 1977).

Validity was established by correlations with clinical ratings of depression, other

self-report measures, and through the relationships with other variables supporting its

construct validity (Radloff, 1977). In response to her work with adolescents and young

adults, Radloff reported that validity is also established by discrimination of clinical from

non-clinical groups. Both reliability and validity for this age group were found to be

similar to earlier reporting of the general population over 18 years of age.

Various studies have addressed the validity and reliability of the CES-D. Umafta-

Taylor and Updegraff (2007) reported a Cronbach's alpha of .91 in a sample of Latino

adolescents, while Roberts, Chen, and Slovitz (1995) reported a Cronbach's alpha of .93

in a sample of Mexican-born adolescents. Roberts et al. (1990) found, in their work with

adolescents grades 9-12, that the CES-D had good internal consistency and test-retest

reliability. Cronbach's alpha was .87 and test-retest correlation was above .50 (boys .49

and girls .60), leading the researchers to conclude that the CES-D is as reliable with

adolescents as it is with adults.

 64

Operational Definition of Variables

The study had four variables: (a) family cohesion, (b) gender, (c) level of

acculturation, and (d) depression. An operational definition of each variable is described

below. Also described is how the primary investigators of the Latino Adolescent

Development project measured and collected their data.

Cohesion. Cohesion involves a oneness or solidarity of a group where the

members experience a sense of belonging and are motivated to adhere to group standards

(VandenBos, 2007). To assess family cohesion, the Latino Adolescent Development

researchers used a nine-item modification of the Cohesion subscale of the FES created by

Moos and Moos (1994).

Gender. Gender was identified on a nominal scale by asking the adolescents

"What is your gender?" (0 = Female, 1 = Male).

Acculturation. Acculturation occurs over a process of time where a group of

people integrates a different culture's social values, beliefs, and behavioral patterns with

those from their culture of origin (VandenBos, 2004). Level of acculturation was

measured by assessing generation status. Generation status involves a person's nativity

and the number of generations that have lived in a particular culture. The first person of a

family to be born in a particular culture is considered first generation. When that person

has children they are considered second generation, and the numerical sequencing

continues with each subsequent generation living in that particular culture (Lee et al.,

2006).

Depression. Depression involves negative thoughts and a change in mood that can

range from sadness to despondency (APA, 2000). A mild form of depression is depressed
 65

mood, which includes depressive symptoms such as change in affect, sleep, or appetite,

but not severe enough to warrant a clinical diagnosis of Major Depression (Georgiades, et

al., 2006). More severe forms of depression often involve sadness, specific criteria can be

found in the DSM-IV-TR (APA, 2000). To assess depression, the primary investigators

used Radloff s (1977) 20-item CES-D for depressed mood.

Data Collection, Processing, and Analysis

The original data was collected by the Latino Adolescent Development subproject

of the Adolescent Resiliency in Multi Cultural Communities (ARMCC) research project

at CSUN. The ARMCC project has three primary purposes, "(1) To identify contextual

factors (neighborhood, family, peer, school) that contribute to youth development in

multi-cultural communities (with a primary emphasis on Latino, Armenian, and Persian

American youth), (2) To educate practitioners, researchers, and educators through

publications and presentations, and (3) To provide a training ground for undergraduate

and graduate student research assistants to enhance their professional development for

graduate school and/or future careers" (Plunkett & Sands, n.d.).

Scott Plunkett and Tovah Sands of CSUN started the ARMCC research project in

2001, combining data they had collected from their individual projects involving four

different schools. Over 10 scholarly journal articles have been published from this data

set (Abarca, Plunkett, & Sands, 2005; Plunkett & Bamaca-Gomez, 2003; Plunkett,

Williams, Schock, & Sands, 2007; Sands & Plunkett, 2005; Supple, Ghazarian, Frabutt,

Plunkett, & Sands, 2006). The project has grown to include three distinct data sets, which

include (a) their original data set, (b) the Latino Adolescent Development research

subproject (data collected from one school), and (c) the Latino Adolescent Research
 66

(LAR) subproject (data collectedfromtwo schools). Nothing to date has been published

from these two subprojects. All projects address similar variables, but they cannot be

easily combined because they utilize mostly different measures (Plunkett & Sands, n.d.).

The following is a step-by-step description of how the instrumentation was implemented.

All graduate and undergraduate student research assistants were required to attend

a training class conducted by one of the ARMCC principal investigators. The assistants

were informed to dress and conduct their interactions with students and staff in a

professional manner. A script was provided for the assistants to review. It included

identification of self, encouragement to answer questions in an honest way, what to do if

questions arise, and an explanation that parents refers to the person(s) who is head of the

household. How to handle potential problems was also addressed (Plunkett & Sands,

n.d.).

The researchers began their actual data collection by distributing the adolescent

consent forms and surveys to students who had returned a signed parental consent.

Research assistants read their script they had learned in the training session. Students who

did not have a parental consent form were given an alternative activity to do while their

classmates completed their surveys. Students signed their consent forms and the

researchers collected them. The researchers then provided instructions for completing the

survey and stayed for the duration of data collection to answer questions (Plunkett &

Sands, n.d.).

To assess family cohesion, the Latino Adolescent Development researchers used

a nine-item modification of the Cohesion subscale of the FES created by Moos and Moos

(1994). Each participating adolescent was asked to rate their response to each item on a
 67

four-point Likert-type scale: \=Not True, 2=Generally Not True, ^Generally True, or

4=True.

To assess depression, the Latino Adolescent Development researchers used

Radloff s (1977) 20-item CES-D for depressed mood. Each participating adolescent was

asked to rate their response to each item on a four-point Likert-type scale. Level of

acculturation was measured by questions assessing generation status and language spoken

in the home between parents and their offspring. 1 = Parents and adolescents were

foreign born. 2 = Parents were foreign born and adolescent was born in the United States.

3 = Parents and adolescents were born in the United States.

Upon completion of the surveys, the assistants read their script thanking the

students for their participation. The researchers gave a brief explanation of the purpose of

the research project. Participants were encouraged to ask questions about the project.

Upon completion of the data collection, a debriefing session was provided for the

research assistants to identify and address issues that might prove helpful in collecting

future data (Plunkett & Sands, n.d.).

Validity of analytical strategy. SPSS Statistics 17.0 statistical software was used

to run the zero-order correlation and the hierarchical multiple regression analyses. A

zero-correlation statistical analysis (i.e., Pearson's correlations) was selected to determine

the strength and direction of the relationship between each independent and the

dependent variable (Tabachnick & Fidell, 2001). In the dataset, gender was dummy

coded (boys = 1, girls = 0) for use in the correlations and regression analyses (Cohen &

Cohen ,1983), allowing it to be used as a continuous variable ranging from 0-1 in the

Pearson correlations (Garson, 2009). This was the appropriate statistical analysis to test
three of the four hypotheses of the study. It provided the strength and relationship

between each independent variable and the dependent variable.

Hla: There is a relationship between family cohesion and depression among

Latino adolescents.

H2a: There is a relationship between gender and depression among Latino

adolescents. Females are more likely than males to develop symptoms of depression.

H4a: There is a relationship between level of acculturation and depression among

Latino adolescents. Latino adolescents who live in a family with a higher level of

acculturation are more likely to experience depression than those who live in a family

with a lower level of acculturation.

A hierarchical multiple regression analysis was appropriate to determine the

amount of variance in the dependent variable created by the linear combination of

independent variables, after identifying the control variable(s) (Plunkett, 2008). This type

of analysis applied because there were two or more independent variables with either

dichotomous or continuous data type, and only one dependent variable with a continuous

data type. This was the appropriate statistical analysis to test the third hypothesis. It

determined the effect that gender had on predicting the influence of family cohesion on

depression.

H3a'- The gender of the adolescent will moderate the relationship between their

reports of family cohesion and depression.

Correlations. Zero-order correlations (i.e., Pearson's correlations) were used to

examine the bivariate relationships between generation status of the adolescent, gender of

the adolescent, family cohesion, and depressed mood. Pearson's correlation coefficients
were used to determine if there is a positive or negative relationship between two

variables that are continuous in nature. The coefficient ranges from a -1 to +1, with a

score of around -1 indicating that there is a strong negative relationship between the

variables, and a score of around +1 indicating the there is a strong positive relationship

between the variables (Moore & McCabe, 2006). If there is a strong negative correlation

then this means that when one variable increased the other variable decreased; while a

strong positive correlation means that when one variable increased the other variable

increased as well.

Hierarchical multiple regression analyses. Hierarchical multiple regression

analyses were conducted to examine (a) the unique contributions of the predictor

variables in explaining variance in adolescent depressed mood, (b) the significance level

of specific beta coefficients within each step of the model, and (c) whether a significant

interaction on depressed mood existed between gender and family cohesion. More

specifically, in Step 1 of the hierarchical multiple regression analysis, gender, generation

status, and family cohesion were entered into the regression equation. In Step 2, gender,

generation status, family cohesion, and gender X family cohesion were entered into the

equation to examine the additional variance explained by the interaction term (i.e.,

beyond gender and family cohesion) and to test possible moderation (Baron & Kenny,

1986).

The advantage of using gender in the multiple regression is that it allows for

examination of family cohesion and gender in the same model. This allows for

determination of how much variance in depression is accounted for by the linear

 70

combination of the two variables together. It also provides the opportunity to determine if

either variable is uniquely related to depression within the context of the other variable.

Prior to creating the interaction term, family cohesion was centered by subtracting

the mean of family cohesion for the total sample from each score for each subject (Aiken

& West, 1991). Then, the interaction term was created by multiplying the centered value

of family cohesion by gender (Aiken & West). All variables were entered into the

regression equation using the default value of .10 as the low level of tolerance to check

for multicollinearity. Also, to test the assumptions of the multiple regression analysis

(e.g., normality, collinearity) the Condition Index, VIF values, histograms for each

variable, and data plots for each variable were checked.

Methodological Assumptions, Limitations, and Delimitations

This study had various limitations. There is no indication that any study has

examined the relationship among family cohesion, gender, level of acculturation, and

depression in Latino adolescents, so the expected outcomes of this study should be

considered preliminary and will need to be replicated. The data were collected through

self-report measures. The potential problem of using these types of instruments is that

some of the data could be artificially inflated because of shared-method variance. This

can occur because subjects responding to a self-report measure are influenced by various

response biases (Whisman, 1997). It is also possible that using generation status to

measure level of acculturation instead of a validated instrument on acculturation, this

variable was not accurately measured.

A sample of 400 Latino students from one public high school in the greater Los

Angeles area is not representative of all Latinos in the United States. Using a descriptive
 71

correlational design prohibits the direct investigation of causality among family cohesion,

gender, level of acculturation, and depression. This type of design has weak internal

validity, which eliminates the researcher's capacity to determine the actual cause of

depression. The investigator can only infer that variables are related.

Several delimitations narrowed the scope of the study. Non-Latino adolescents

were eliminated from the study because this proposed study is a response to the lack of

research conducted to date on the relationship among the four variables in Latino

adolescents. Numerous physiological, psychological, and social changes occur during

adolescence that influence the rates of depression in early and late adolescence. Therefore

it was decided to narrow the age range of the participants to predominantly 14-15 to limit

the potential that age was a confounding variable. Peer support, socioeconomic status,

and psychotropic medication could have been included as variables to reduce their role as

potential confounding variables. They were not included for two reasons: (a) the primary

focus of the study is the influence of family cohesion, gender, and level of acculturation

on depression, and (b) limits of the original data collected by the primary investigators of

the Latino Adolescent Development project. A cross-sectional descriptive method was

chosen instead of a longitudinal one because a snapshot view of the participants was

deemed more important than how they change throughout adolescence.

Ethical Assurances

The dissertation project did not involve human subjects because it is a secondary

data analysis. The data collected by the Latino Adolescent Development is codified

private information. The names of the participants that match the codes are stored on a

password protected computer and in a locked file cabinet in one of the principal
investigators' office. In the projects' research lab, the self-report surveys are locked in a

file cabinet and the SPSS data file is stored on a password-protected computer. Other

than the three-digit code, no identifying information exists on the surveys or the data file

(Plunkett & Sands, n.d.). For this study of a secondary data analysis, no direct contact

with human beings occurred. In addition, it is not possible for this investigator to

determine the actual identity of the subjects.

The Latino Adolescent Development project was approved by CSUN's

Institutional Review Board. The principal investigators complied with numerous

regulations of the U.S. Department of Health and Human Services. Voluntary informed

consent was obtained from the parents and consent was obtained from the adolescents.

Both were delivered in a language that was understandable. Research assistants read a

script to participants explaining how to deal with potential problems during data

collection. Participants were debriefed and encouraged to ask questions after the data had

been collected.

The rights, privacy, and welfare of research participants were met through proper

use of confidentiality. A three-digit identification number system was used with the

surveys, while the list of names was protected in a password protected computer and kept

under lock and key in file cabinets. It appears that the original researchers provided

justice as they did not offer potentially beneficial research to some and exclude others,

nor did they discriminately select certain individuals for high-risk research. The

researcher believes that this project represents a fair distribution of both the benefits and

the burdens of the Latino population who participated in the research. Justice implies that

their representation means is fair and just considering the potential risks and benefits
 73

associated with the research. It does not mean that each group will have equal

representation (National Institutes of Health Training, 2008).

Given the demographics and distribution of the research participants, the

researcher believes that an equitable distribution of risks and potential benefits exist. The

expected dissertation study has an appropriate distribution of gender, ethnic, and age of

those that may benefit from knowledge gained by the project. This group of adolescents

recruited by the original researchers does not appear to have been unduly burdened, and

the recruitment reflects the diversity of the population who might benefit from the

outcomes. The risks involved for this research project appear to have been addressed by

the investigators who collected the original data. The benefits far exceed the risks as this

project has the potential to add to the generalizable knowledge base of depression among

adolescent Latinos.

To comply with NCU requirements and federal regulations, the research was

reviewed and approved by the NCU IRB committee prior to data collection. The study

was a secondary data analysis and did not involve interaction with participants to collect

the data, however it did involve human subjects and so IRB approval was sought. IRB

review and approval was intended to ensure the welfare of research participants and help

the investigator conduct ethical research.

Summary

The study used data collected by the Latino Adolescent Development project of

CSUN on Latino adolescents at a Los Angeles, California high school. The original

investigators used a questionnaire form to collect data on numerous variables related to

Latino adolescents. This research study used data collected on four variables, which
 74

included (a) gender, (b) level of acculturation, (c) family cohesion, and (d) depression.

Gender was identified by using a nominal scale and level of acculturation and by

identifying generation status. A nine-item modification of the Cohesion subscale of the

FES (Moos & Moos, 1994) measured family cohesion. Depression was assessed by using

the 20-item CES-D (Radloff, 1977).

To determine if the four predicted relationships existed, a quantitative method

cross-sectional descriptive correlational design was used. This design was chosen to

determine the strength of relationship among depression and the three other variables.

Correlation analysis, multi-linear regression analysis, and analysis of variance were

conducted to determine the main effects of the three independent variables. The

interactive effects of the variables were then determined. The analysis then attempted to

explain if gender was a moderator variable of family cohesion and depression influencing

the direction and strength of each variable.

The problem of collecting data through self-report measures is that the results for

each of the variables could have been artificially inflated. A sample of 400 Latino

students is not representative of all Latinos in the United States. Using a descriptive

correlational design prohibited the direct investigation of causality among family

cohesion, gender, level of acculturation, and depression. To address these limitations the

study should be replicated in different locations in the United States. Since the study was

a secondary data analysis, the dissertation project did not involve human subjects. It was

not possible for this investigator to determine the actual identity of the subjects because

the study did not have direct contact with human beings and the data was codified private

information.
 75

CHAPTER 4: FINDINGS

The purpose of this study was to determine if there was a significant relationship

among family cohesion, gender, level of acculturation, and depression in Latino

adolescents, and to determine if gender moderated the relationship between family

cohesion and depression. Significant relationships were found between family cohesion

and depression as well as gender and cohesion. A significant relationship did not exist

between level of acculturation and depression, and gender was not a moderating variable.

This chapter includes the results and evaluation of the research findings. The findings are

interpreted compared to other studies that were presented in the literature review chapter.

Results

Zero-order Correlations. The means, standard deviations, ranges, and results of

the zero-order correlations (also referred to as Pearson correlations) are reported in Table

1. Support was provided for Hypotheses 1 and 2, but not for Hypothesis 4.

Variables I 2 3 4

1. Depression -

2. Family Cohesion -.33** -

3. Gendera -.26** .16**

4. Generation status -.06 .08 .07

Mean .94 2.89 .46 1.89

SD .51 .51 .50 .42
Range 0-3 1-4 0-1 1-3
a
0 = girls, 1 = boys.
*p<.05. **/?<.01.

Table 1: Correlations and Descriptive Statistics (n — 400)

 76

Hypothesis 1 addressed the relationship between family cohesion and depression

and it was hypothesized that there would be a significant relationship between the two.

The results supported the hypothesis; family cohesion was significantly and negatively

related to adolescent depression (r = -.33;p <.001), as shown in the scatter plot (Figure

1)-

20H

e
.2

«8 v
Q o o
o o o
o ° o o
© o
O O o
0.5-

0.0 ' I
15 2:0 25 30 40
Family Cohesion

Figure 1. Scatter Plot ofFamily Cohesion and Depression.

Hypothesis 2 addressed the relationship between gender and depression and it was

hypothesized that females would be more likely than males to develop symptoms of

depression. The results supported this hypothesis as females reported significantly higher

levels of depressed mood than males (r = -.26; p < .001), as shown below (Figure 2).
 77

1.1-

1.0-
o
"55
</>
a>
a.
a>
a
c
CD
<U 0.9-

0.8"
•

1 1 1 1 I
0 0 0
1 1 1
Gender
0 = Female 1 = Male

Figure 2. Mean Depression ofFemales and Males.

Hypothesis 4 addressed the relationship between level of acculturation and

depression. Although it was hypothesized that there would be a relationship between

level of acculturation and depression, the results did not provide support (r = -.06; p -

.14), as shown in the histogram (Figure 3).

 78

-i.oo 1.50 2.00 2.50 3.00

Generation Status

Figure 3. Histogram of Generation Status and Depression.

Hypothesis 3 addressed gender being a moderator variable between family

cohesion and depression. It was hypothesized that gender would moderate the

relationship between these two variables. Results indicated that only for females were

gender and family cohesion significantly and positively related to each other (r =. 16; p <

.001). This indicated that females reported significantly higher family cohesion than

males. Hypothesis 3 was additionally addressed in the multiple regression hierarchical

analysis. To ensure there were no underlying problems, assumptions of correlations were

addressed.

There are various assumptions associated with the Pearson Correlation

Coefficient that were met by this study. When the variables were plotted on x-y charts

there was a linear relationship between both variables, enabling the coefficient to

measure the relationship's approximation to a straight line is (Lohninger, n.d.; Statistics

 79

Tutorials, n.d.). The random variables were continuous and measured on interval scales to

allow rank ordering, quantifying, and comparing the differences of sizes between them

(Lohninger; StatSoft, 2010). They were bivariately normally distributed (Lohninger;

Northern Arizona University, n.d.), independent of one another, and represented a

random sample of the population (Lohninger; StatSoft).

Hierarchical multiple regression analyses. The results of the hierarchical multiple

regression analyses are presented in Table 2. Since generation status was not statistically

significant to any of the other variables in the correlations, it was not included in the

hierarchical multiple regression analysis.

Model 1 Model 2

Variable B SE fi ' B SE 8

Gender8 -.22 .05 -.22** -.22 .05 -.22**

Family Cohesion _30 05 _ 3 0 ** ..32 .06 -.32**
Family Cohesion X Gender 06 .10 .03

^change .16 .00

F change in R2 36.50** .33

a
0 - female, 1 = male.*/? < .05. **p < .01.

Table 2 Hierarchical Multiple Regression Analyses (n = 400)

In Step 1, Hypothesis 1 was supported {beta = -.30,/? < .001). Family cohesion

and gender accounted for 16% of the variance of depressed mood in adolescents (F

change = 36.50,/? < .001). Hypothesis 2 was supported as gender was significantly and

negatively related to depressed mood (beta = -.22, p < .001). Additional analyses were

conducted in Step 2.
 In Step 2, gender remained significant as females reported greater depressed

mood than boys (beta - -.22, p < .001). Hypothesis 2 was supported as family cohesion

was significantly and negatively related to depressed mood (beta ~ -.32, p < .001). The

results failed to support Hypothesis 3 as there was no support for gender having a

moderating effect. The interaction of family cohesion X gender was not significantly

related to depressed mood (beta - .03, p = .57). The interaction did not explain a

significant amount of the incremental variance (0%) above gender and family cohesion

(F change = .33,p < .57). These findings are shown in the following chart (Figure 4).

Hypothesis 4 was not supported as generation status was not significantly related to

depressed mood (r = -.06; p = .14).

.32
Family Depressive
Cohesion Symptoms

.03
F= 36.50**

Gender
(0 = female 1 = male)

**p < .01. Note: Dotted line represents non-significant interaction between genders and
family cohesion.

Figure 4. Hierarchical Multiple Regression Analyses for Latino Adolescents' Perceptions

of Family Cohesion, Gender, and Depressive Symptoms

A default value of .10 was set as the low level of tolerance. After all of the

variables were entered into the hierarchical multiple regression equations, the Condition

Index ranged from 1.00-16.98 with only one variance proportion greater than .50. The
 81

VIF ranged from 1.03 to 1.67, which is well below the cutoff of 4.0. Examination of data

plots and histograms for the individual variables and the residuals in the regression did

not indicate any violations of the normality assumption (Tabachnick & Fidell, 2001),

Examination of the residual plots in the regression equations did not indicate any

nonlinear relationships (Cohen & Cohen, 1983).

Evaluation ofFindings

Family cohesion. According to family systems theory, family members are

interconnected with one another. To fully understand an adolescent within their family,

the interactions among family members must be analyzed. Family cohesion, an indicator

of closeness among family members, is one component of family systems theory and

provides a good way to understand the closeness of the system. The findings indicate that

family cohesion was significantly and negatively related to adolescent depression. This

supports a body of literature that family cohesion, a global indicator of family support, is

positively related to family functioning during adolescence (Chapman & Perreira, 2005).

It also concurs with Baer (2002) and O'Donnell et al.'s (2004) finding that cohesion is a

protective factor that functions as a buffer against stressful situations.

Lack of cohesion within the family has numerous outcomes. Burt et al. (2005) and

Vandewater and Lansford (2005) indicate that unresolved conflict between mothers and

adolescents is positively correlated with adolescent depression. Discord among the entire

family is also related to adolescent depression (Cuffe et al., 2005). Rivera (2007) found

that perceived social support from families is related to lower levels of psychological

distress among Latino adolescents. The findings of this study add to the contextual

understanding of adolescent depression. It also adds to a growing knowledge base on the

 82

effects of cohesion within Latino families, specifically upon the adolescent. Family

cohesion has been shown to have a protective value (Rivera et al. (2008), decrease levels

of psychological distress (Rivera (2007), and enhance parent-child relationships in Latino

adolescents (Corona et al., 2005; Herman et al., 2007).

Gender. The analysis revealed that females reported significantly higher levels of

depressed mood than males. Thisfindingis consistent with the APA (2000) study that

across all ethnicities females experience more depressive symptoms than males.

Although the sex ratio for depression among pre-pubescent children is approximately

equal for boys and girls (Roza et al., 2003), this study contributes to thefindingby Li et

al. (2006) that during middle and late adolescence twice as many females experience

depression than males.

The results support thefindingson frequency and risk factors of depression in

Latino adolescents. Barrera (2006) found that Latina females manifest symptoms of

clinical depression at a higher rate than Latino males. The Centers for Disease Control

and Prevention (2006) study with 14-18 year old adolescent Latinos found that Latina

females experienced double the amount of depressive symptoms as Latino males.

Chapman and Perreira (2005) found that Latina female gender is related to greater

psychological distress and is a risk factor for depressive symptoms.

Gender as a moderator. Although thefindingsof this study reveal significant

relationships between family cohesion/depression and gender/depression, it also revealed

that gender did not moderate the relationship between family cohesion and depression.

This implies that each variable operates independent of the other in its impact upon

depression. Thisfindingis inconsistent with other studies because gender is usually

 83

described as a moderating variable. Dao et al. (2006) found that gender moderated the

effect of past experience(s) of victimization on nonspecific psychological distress.

Lanthier & Windham (2004) found it moderated use of the Internet on academic

adjustment and total adjustment. Bekker et al. (2007) examined sex differences in various

types of attachment styles and autonomy/connection patterns. They discovered that

gender moderated the relationship between anxious/avoidant attachment and

antisocial/passive-aggressive behavior. No studies were found that examined gender as a

potential moderator of the relationship between family cohesion, level of acculturation,

and depression in adolescent Latinos. This finding of this study that each variable

operated independently of one another may imply that this occurs when the dependent

variable is depression, but not with other dependent variables.

Level of acculturation. The interdependence of systems and their influence on

individual growth and development is a key component of human ecological theory

(Bronfenbrenner, 2005). Particular emphasis is given to the reciprocating relationship that

the family has with multiple systems. Due to the powerful influence that culture has upon

families and individuals, and the psychological disruption that occurs through

immigration, it was hypothesized that generation status would be significantly related to

depressed mood. Therefore, it was surprising to find no significant relationship between

the two.

Most of the literature on these variables reveals a significant relationship between

level of acculturation and adolescent depression. Gonzales et al. (2006) found that as

adolescents acculturated to the host culture their mental health symptoms increased.

Garcia (2007) found that acculturative stress was significantly related to depressive
 84

symptoms and suicidal ideation. Also, Brown et al. (2007) found that generation status

had a significant effect on trajectories of depression symptoms of Latino adolescents.

These and other studies have lead scholars to conclude that high levels of involvement in

traditional Latino family values serve as a protective factor against depression (Umana-

Taylor & Updegraff, 2007).

In this study, generation status was not significantly related to depressed mood,

contradicting the findings discussed above. However it does support other findings that

increased level of acculturation and increased mental health symptoms do not apply to all

Latino adolescents. One study revealed decreased levels of depression as Latinos

acculturate into the mainstream culture and attribute this to increased cultural

competency. Torres and Rollock (2007) indicate that intercultural competence moderates

the relationship between acculturation and depression in Latino adults concluding that

active and competence-based problem-solving orientation to acculturation resulted in

fewer symptoms of depression. While it is uncertain if intercultural competency

influenced the participants of the current study, it does support the current trend among

scholars to look comprehensively at all the factors that are related to acculturation and

depression.

Summary

Statistical analyses using Pearson correlations and hierarchical multiple regression

analyses produced findings that confirmed the first two hypotheses of the study, but not

the last two. Regarding the first research question, family cohesion was significantly and

negatively related to adolescent depression. An investigation of the second question

found that females reported significantly higher levels of depressed mood than males. For
 85

the third hypotheses, the gender of the adolescent did not moderate the effects of

cohesion on depression. Addressing the fourth question, generation status was not

significantly related to depressed mood.

The significant relationship between family cohesion and depression is supported

by much of the literature. The literature also supports the significant relationship between

gender and depression, with females reporting higher levels of depressed mood than

males. Although the majority of studies found gender functioning as a moderator

variable, this study did not reveal this trend. However, none of the other studies included

the variables of this one (Bekker et al., 2007; Conn & Modecki, 2007; Dao et al, 2006;

Lanthier & Windham, 2004). No significant relationship between level of acculturation

and depressed mood reinforces the importance of carefully investigating all of the factors

related to these two variables. The implications and recommendations of this study are

presented in the next chapter.

 CHAPTER 5: IMPLICATIONS, RECOMMENDATIONS, AND CONCLUSIONS

Adolescent depression is a problem because it has been shown to relate to

numerous negative outcomes, including difficulty with psychosocial adjustment,

substance abuse, and increased suicidal ideation and attempts (Paradis et ah, 2006). In the

United States, Latino adolescents have the highest rates of depressive symptoms of all

cultural groups, and female Latina adolescents have a higher rate of depressive symptoms

than their male counterparts (SAMHSA, 2008). The purpose of this study was to

determine if there was a significant relationship among family cohesion, gender, level of

acculturation, and depression in Latino adolescents. Because this occurred, it was

determined if gender moderated the relationship between family cohesion and depression.

A quantitative design and cross-sectional descriptive correlational method was

used to analyze an existing dataset from the Latino Adolescent Development research

project of California State University Northridge. Pearson's correlations were used to

examine the bivariate relationships between family cohesion, gender of the adolescent,

generation status, and depressed mood. A hierarchical multiple regression analysis was

conducted to determine the main and interactive effects of the three independent

variables. It was also used to determine if gender was a moderator variable of family

cohesion and depression influencing the direction and strength of each variable. The

study, however, did have various limitations.

The outcomes must be considered preliminary and need to be replicated because

there is no indication that any study has examined the relationship among these variables

with Latino adolescents. The data were collected through self-report measures so there

was the potential that some of the data could be artificially inflated because of shared-
 87

method variance. It is possible that level of generation was not accurately measured

because generation status was used instead of a validated instrument on acculturation. A

sample of 400 Latino studentsfromone public high school in the greater Los Angeles

area is not representative of all Latinos in the United States. Using a descriptive

correlational design with weak internal validity prohibits the direct investigation of

causality. In spite of these limitations, there were numerous steps that were taken to

ensure the welfare of its participants.

Standard ethical assurances were met and IRB approval obtained. The project did

not involve human subjects because it was a secondary data analysis of the Latino

Adolescent Development Project. The original investigators' material contained codified

private information, and the names of the participants matching the codes are stored on a

password protected computer and in a locked filed cabinet. They received approval from

their Institutional Review Board at California State University Northridge substantiating

that the rights, privacy, and welfare of the research participants were met through proper

use of confidentiality. This current project represents a fair distribution of both the

benefits burdens of the Latino population who participated in the research. It also

contains an appropriate distribution of gender, ethnic, and age of those that may benefit

from knowledge gained by the project. To comply with NCU requirements and federal

regulations, the research project was reviewed and approved by the NCU IRB committee

prior to data collection.

This chapter begins with a brief presentation of the problem statement.

Implications are presented by describing logical conclusions that emerged from each of

the four research questions and their correlating hypothesis. Potential limitations that may
 88

have affected the interpretation of the results are also described, as well as how the results

fit with the purpose, significance, and research described in the literature review. The

chapter concludes with recommendations for practical applications of the study.

Implications

Latino adolescents have the highest rates of depressive symptoms of all cultural

groups. Among Latino adolescents, females have a higher rate of depressive symptoms

than males (SAMHSA, 2008). This is a problem because adolescent depression has been

shown to relate to numerous negative outcomes. Some of these include substance abuse,

difficulty with psychosocial adjustment, and increased suicidal ideation and attempts

(Paradis et al., 2006).

Family cohesion. When adolescents perceive their families as cohesive (e.g.

support, love, and bonding), they internalize positive feelings about themselves and the

world they live in. This positive approach to self and daily challenges can empower them

to feel like life stressors are more manageable. Sustaining a positive cognitive approach is

one factor that minimizes the propensity to experience depression. For over thirty years

research on cognitive behavioral therapy has revealed a significant negative correlation

between positive cognition and depression (Beck, et al., 2004; Beck, et al., 1979; Haaga,

et al., 1991; Robertson & Simons, 1989).

The opposite is true about adolescents who perceive their families as non-

cohesive or disengaged. It is very possible that because they do not experience the

support of their family they believe that daily stressors are very difficult to successfully

cope with and overcome. This could lead to internalization of negative messages about
self and the world they live in resulting in depression (Haaga et al., 1991). A positive or

negative family environment is of great importance to Latino adolescents.

In this study family cohesion was significantly related to depression among

Latino adolescents. Because family closeness or cohesion is highly valued and expected

in Latino families, it is possible that Latino adolescents are very responsive to a decrease

in cohesion. The adolescent could then internalize a negative cognitive script which

would place them at risk of depression. The logical conclusion is that family closeness is

essential for the mental health of its adolescents. Those families that cultivate and sustain

this closeness create a healthy environment for their adolescent which decreases their

chances of experiencing depression.

Gender. Investigation and analysis of the second research question revealed that

gender is significantly and negatively related to depressed mood. It also revealed that

females reported higher levels of depression than males. This seems to indicate that girls

are socialized to internalize their negative emotions while boys tend to externalize them

through acting out behaviors such as violence. Internalizing the energy of unpleasant

emotions can contribute to depression. The logical conclusion is that Latina female

adolescents continue to be at high risk for depressed mood and episodes of depression

throughout their life. Therefore it is imperative that the individual, familial, and societal

factors contributing to depression be understood and changed for optimal mental health in

all Latino adolescents.

Gender as moderator. Gender did not moderate the relationship between family

cohesion and depression. This reveals that family cohesion has a significant relationship

with depression regardless of the gender of the adolescent. The logical conclusion is that
 90

family cohesion and gender each have their own relationship with depression but do not

influence one another. Yet gender's role as a moderator variable was hypothesized

because in Latino families females are socialized to be closer to their family than males.

Therefore it is also possible that confounding variables neutralize the role of gender in

this capacity.

Level ofAcculturation. Generation status was not significantly related to

depressed mood. The logical conclusion is that acculturation is not related to depression.

Rather it is possible that (1) the value each family puts on closeness, and (2) how each

gender either internalizes or externalizes stress, are the influential factors upon

depression. In this study generation status was used as a proxy variable for acculturation.

Another logical conclusion is that generation status may not be the best indicator of

acculturation. This would imply that Latinos in the Los Angeles area retain their cultural

values and behaviors across generations.

Potential Limitations. There are potential limitations that may have affected the

interpretation of the results. The three areas of concern involve: (1) the sample, (2) the

measurements of the variables, and (3) the research method and statistical analysis of the

data. The sample is limited as the data was collected from only one school in Los

Angeles. The majority of the Latino participants were of Mexican and Central American

decent. Because of the sampling, the capacity to generalize to other Latino Americans

located in other states (e.g. Texas, Florida, and New York) is limited. In addition, the

sample was almost entirely ninth-grade students. Because of the many physical,

psychological, and social changes that occur during adolescence, these results may be

different in other age groups.

 91

The measurement of the selected variables is also a potential limitation. The study

was only comprised of data collected from adolescent self-reports. A concern with this

type of instrument is shared method variance. The unrelated variables may be linked

because they were collected using the same method (Martina, Levyb, Pieka & Haya,

2006; Willcutt, Pennington, & DeFries, 2000). This increases the potential to inflate the

strength of the relationship of the variables. Another limitation is that generation status

was used instead of a validated measure to assess acculturation. Only family cohesion

was used as an indicator of overall family functioning. There are additional ways to

measure the functionality of the family unit.

A cross-sectional descriptive correlational method was used for this study. While

this type of method provides a good understanding of the adolescent subjects at a given

point in their development, the potential limitation is that it may not be representative of

their depressive symptoms over time. The use of a hierarchical multiple regression

analysis is also a potential limitation. With this type of statistical analysis it is only

possible to understand the relationship between the variables but does not reveal causal

components (StatSoft, 2010).

How resultsfit.The purpose of the study was to determine if there was a

significant relationship among cohesion, gender, level of acculturation, and depression in

Latino adolescents, and to determine if gender moderated the relationship between the

effects of family cohesion on depression. The objectives were met as it was discovered

that cohesion and gender were significantly related to depression but level of

acculturation was not, and that gender was not a moderating variable.
 The results fit with the significance of the study because the findings represent a

contribution to Latino mental health, adolescent intervention programs, and effective

public policy. These findings add to limited existing information on Latino adolescent

mental health. From this study, mental health providers and clinical practitioners should

be helped in their delivery of services. These results may benefit the best practices for

intervention programs involving adolescents at risk for depression. They may also assist

in establishing effective public policy aimed at preventing and reducing adolescent

depression.

The results of this study concur with some of the findings of the existing literature

but contradict with others. From the lifespan developmental perspective, there are

multiple cognitive, social-emotional, and physiological changes that occur during this

stage of development (Martin & Fabes, 2009). The findings of this study support other

literature (Pettit et al., 2009) that adolescents are at an increased risk of experiencing

depression. The finding that family cohesion was significantly related to depression

supports numerous studies that family cohesion serves as a protective factor for

adolescent depression (Galambos, et al. 2004; Herman et al., 2007; Meadows, et al.,

2006; Stice, et al., 2004). From a family systems perspective, the findings support other

literature that family cohesion is a global indicator of family support and is positively

related to family functioning during adolescence (Chapman & Perreira, 2005). The

traditional Latino family is a highly cohesive group functioning as a protective factor for

the adolescent (Baer & Schmitz, 2007). The findings support this and other studies that

when the Latino family is not cohesive this adolescent protective function erodes

(Cespedes & Huey, 2008; Corona et al., 2005; Gonzales, et al. Knight, 2002).
 93

That gender was significantly related to depression supports studies that Latina

females manifest symptoms of clinical depression at a higher rate than Latino males

(Barrera, 2006; Hernandez, 2006). The ratio of females to males who experienced

depression in the study support the finding of Li, et al. (2006) and Hazier and Mellin's

(2004) review of the literature that during middle and late adolescence nearly twice as

many females than males experience depression. The findings of this study revealed that

gender did not moderate the relationship between other variables. This is inconsistent

with the literature where gender usually functions as a moderator. However, in none of

those studies were family cohesion and depression the variables under investigation.

It was hypothesized that there would be a significant relationship between level of

acculturation and depression because most of the literature reveals level of acculturation

is related to numerous psychological difficulties (Caplan, 2007; Chapman & Perreira,

2005; Espin, 1999; Miranda et al., 2006; Romero & Roberts, 2003). The literature also

reveals that acculturated adolescents experience greater mental health symptoms than

their less acculturated counterparts (Gonzales et al., 2006; Pena et al., 2008). These

findings have lead scholars to the conclusion that supportive relationships protect the

adolescent against depression (Galambos et al., 2004; Gutman & Sameroff, 2004), and

that high levels of involvement in traditional Latino family values serves as a protective

factor against depression (Caplan, 2007; Crockett et al., 2007; Umana-Taylor &

Updegraff, 2007). Contrary to all of the studies cited above, this study revealed no

significant relationship between level of acculturation and depression. Rather it is

consistent with an emerging body of literature finding decreased levels of depression as

Latinos acculturate into the mainstream culture (Torres and Rollock, 2007).
Recommendations

Clinical practitioners and other mental health providers who work with families

from diverse ethnic backgrounds may benefit from this study. Understanding the

relationship between family cohesion, gender, and depression can give providers a

renewed focus in their delivery of their services. Professionals working with Latino youth

may want to capitalize on the value of familism as a buffer to depression. This could be

done by utilizing therapeutic sessions, prevention programs, and interventions strategies

that encourage cohesion-oriented family activities. The finding that Latina adolescents

experience depression at a higher rate than their male counterparts should assist in

creating best practices for intervention programs with at-risk youth. Public policy should

be aimed at helping all Latino adolescents who experience the highest rate of depression

among all adolescents.

Recommendations for future research include additional possibilities for

collecting and analyzing data. Future studies should collect data from Latinos in different

schools, with different adolescent age groups, and in different geographic locations. In

addition to utilizing participants in different states within the United States, scholars may

also want to examine other Latino groups from the Caribbean and South America. With

this additional data it would be helpful to examine intergroup and intragroup differences.

There are additional ways that future studies could better understand adolescent

depression in Latino adolescents. In this study only the adolescent's perception of family

cohesion and depression were measured, but it could prove helpful to gather this

information from other family members. Family cohesion was used as an indicator of

overall family functioning. Resiliency, flexibility, and characteristics of the parent-child

 95

dyad could be investigated in future studies. Researchers may want to use an

acculturation scale and/or an acculturative stress scale to investigate the relationship

between acculturation and depression. Utilizing a longitudinal design would facilitate a

greater understanding of the relationship between family cohesion and depression in

Latina females and Latino males.

Conclusions

Limitations of the study include three areas of concern: (1) the sample, (2) the

measurements of the variables, and (3) the research method and statistical analysis of the

data. In spite of these limitations, the results indicate: (1) family cohesion is essential for

the mental health of adolescents and decreases the chances of depression, (2) females

report higher levels of depression than males so Latina female adolescents continue to be

at high risk for depressed mood and episodes of depression throughout their life, (3) there

is no moderation effect for gender on family cohesion and depression suggesting that

family cohesion and gender each have their own relationship with depression but do not

influence one another, and (4) the value that the family puts on closeness and how each

gender either internalizes or externalizes stress may have a stronger relationship with

depression than level of acculturation.

Suggestions for future studies include collecting data from Latinos in different

schools, with different adolescent age groups, and in different geographic locations. With

this additional data it would be helpful to examine intergroup and intragroup differences.

Researchers could assess other factors of overall family functioning including resiliency

and flexibility, and investigate characteristics of the parent-child dyad (e.g. parental

support, involvement, and control). Gathering information from other family members
could be beneficial as well as could measuring level of acculturation by using an

acculturation scale and/or an acculturative stress scale.

Even with the limitations, this study is a response to a growing concern that

Latino adolescents have the highest rates of depressive symptoms of all cultural groups.

Thefindingssupport other research that Latina females have a higher rate of depressive

symptoms than Latino males (SAMHSA, 2008). The results of this study support that

family cohesion functions as a buffer against depression in Latino adolescents.

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APPENDIXES
 119

Appendix A

Demographic Questionnaire

In what country were you born?

If not born in the U.S., how many years have you lived here?

In what country was your mom born?

If not born in the U.S., how many years has she lived here?

In what country was your mom's mother born?

In what country was your mom's father born?

In what country was your dad born?

If not born in the U.S., how many years has he lived here?

In what country was your dad's mother born?

In what country was your dad's father born?

Which language(s) are spoken in your home? Which language is spoken most often in

your home? How well does your father speak English?

0. Not at all 1. Not very good 2. Pretty good 3. Very good 4. Fluent

How well does your mother speak English?

0. Not at all 1. Not very good 2. Pretty good 3. Very good 4. Fluent

What is your age? What is your grade?

What is your gender?

In terms of an ethnic group, I consider myself to be

How many years have you lived in your neighborhood? How would you describe the

wealth of most of the families in your neighborhood? Who do you live with?
 Appendix B

The Family Environmental Scale

How true Not True Generally Not Generally True TRUE

is each True
statement?
1. Family 1 2 3
members
really help
and support
one another.
2. We often 1 2 3
seem to be
killing/wastin
g time at
home. (RC)
3. We put a lot 1 2 3
of energy into
what we do at
home.
4. There is a 1 2 3
feeling of
togetherness
in our family.
5. We rarely 1 2 3
volunteer
when
something
has to be
done. (RC)
6. Family 1 2 3
members
really support
each other.
7. There is very 1 2 3
little group
spirit in our
family. (RC)
8. We really get 1 2 3
along with
each other.
9. There is 1 2 3
plenty of time
/attention for
all in family.
 121

Appendix C

The CES-D Scale

How often have Rarely or noneof Some or a little Occasionallyor a Mostly or

you felt the the time (less of the time(l-2 moderate amount almostall the
following ways than 1 day) days) of the time time(5-7 days)
DURING THE (3-4 days)
PAST WEEK?
1. I was bothered 0 1 2 3
by things that
usually don't
bother me.
2. I did not feel 0 1 2 3
like eating;
my appetite
was poor.
3. I felt that I 0 1 2 3
could not
shake off
feelings of
sadness, even
with help
from family
and friends.
4. I felt that I was 0 1 2 3
just as good
as other
people. (RC)
5. I had trouble 0 1 2 3
keeping my
mind on what
I was doing.
6. I felt 0 1 2 3
depressed.
7. I felt that 0 1 2 3
everything I
did took a lot
of effort.
8. I felt hopeful 0 1 2 3
about the
future. (RC)
9. I thought my 0 1 2 3
life had been
a failure.
10.1 felt fearful. 0 1 2 3
 122

11. My sleep was 0 2 3

restless.
12.1 was happy. 0 2 3
(RC)
13.1 talked less 0 2 3
than usual.
14.1 felt lonely. 0 2 3
15. People were 0 2 3
unfriendly.
16.1 enjoyed life. 0 2 3
(RC)
17.1 cried at 0 2 3
times
18.1 felt sad. 0 2 3
19.1 felt that 0 2 3
people
disliked me.
20.1 could not
0 1 2 3
get "going".