DIFFERENTIAL PREDICTORS OF SUBJECTIVE WELL-BEING IN A LATINO

CLINICAL SAMPLE

BY

Nerina Garcia
B. A., Stanford University, 1997
M. A., Fordham University, 2002

DISSERTATION
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT
OF PSYCHOLOGY AT FORDHAM UNIVERSITY

NEW YORK
November 14,2007
 UMI Number: 3301437

Copyright 2008 by
Garcia, Nerina

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 PORDHAM UMVEKSnr
THB JESUIT UNIVERSITY OF NEW YORK

GRADUATE SCHOOL OF ARTS AND SCIENCES

Date: November 14, 2007

This dissertation entitled Differential Predictors of Subjective Weil-Being

In a Latino Clinical Sample,

Prepared by Nerina Garcia

Under the Direction of

Dr. Cecero I I (JL-OCA^—-

/JM^NTOR,

D r . McKay hiju^-
READER

Dr. Rivera-Mindt
READER

READER

Has been accepted in partial fulfillment of the requirements for the

Doctoral Degree

in the Department of:

Psychology

Department Chairperson Dr. Fred Wertz

 DEDICATION

This dissertation thesis is dedicated to my parents, Luis and Simona Garcia, who
instilled a belief in achieving your life goals despite adversity. Thank you both for
having the courage to cross the Mexican American border in the hope of achieving a
better life for you and your future children. Through your hard work and example I
believed in myself and was able to pursue and achieve the unexpected. Gracias mami y
papi.

I would not have succeeded thus far without the love and support of my "little"
brothers, Leo and Andy, and my large extended family. All of your encouragement,
voice messages, and mail helped keep me motivated here in New York.

Erich, this final phase of my education was easier because of you. Your
unflinching belief in my abilities has helped me through some of the hardest moments of
this process. Words cannot express the depth of my appreciation. Thank you for your
love. Thank you for being my biggest ally and supporter.
 11

TABLE OF CONTENTS

Page
Table of Contents ii

CHAPTER I: INTRODUCTION 1

Thesis 1

Literature Review 5

Rationale for Culturally Specific Research 5

Subjective Weil-Being 9

Theoretical Predictors of Subjective Well-Being 11

Weil-Being and Latinos 13

Five Factor Model of Personality 14

Evolution of the Five Factor Model of Personality 15

Five Factor Model of Personality and Well-Being 17

Five Factor Model of Personality, Well-Being and Culture 23

Psychological Mindedness 25

Theoretical Foundation of Psychological Mindedness 26

Etiology of Psychological Mindedness 32

Psychological Mindedness and Well-Being 35

Acculturation 38

Theoretical Models of Acculturation 39

Psychological Effects of Acculturation on Well-being 46

 iii

Purpose and Rationale 52

Conceptual Hypotheses 53

CHAPTER II: METHOD 55

Participants 55

Procedures 58

Instrument Translation Procedure 58

Instruments 59

Five Factor Model of Personality 59

Psychological Mindedness 61

Acculturation 62

Subjective Weil-Being 64

Demographic Data 68

Informed Consent 68

Operational Hypotheses 69

CHAPTERIII: RESULTS 72

Descriptive Statistics 72

Measure Descriptives 72

Translated Measures 75

Correlations of Demographics with Dependent Variables 75

Correlations of Independent and Dependent Variables 76

Inferential Statistics 78

Hypothesis Testing 79

Post Hoc Analyses 86

 IV

CHAPTER IV: DISCUSSION 94

Five Factor Model of Personality and Subjective Weil-Being 95

Psychological Mindedness and Subjective Weil-Being 98

Acculturation and Subjective Well-Being 100

Additional Analyses of Acculturation 104

Limitations of the Current Study 105

Clinical Implications 107

Suggestions for Future Research 109

CHAPTER V: SUMMARY 110

Introduction 110

Method 115

Results 120

Discussion 129

References 140

APPENDIX A 160

APPENDIX B 164

APPENDIX C 169

APPENDIX D 171

APPENDIX E 173

APPENDIX F 183

APPENDIX G 193

Abstract

Vita
 V

LIST OF TABLES AND FIGURES

Table

1. Definitions of Psychological Mindedness 27

2. The Nine Levels of Psychological Mindedness 28

3. Summary of Demographic Information 56

4. Demographic Information: Country of Origin 57

5. Scale Descriptive Statistics 73

6. Correlations between Independent and Dependent Variables 77

7. Multiple Regression Predicting Subjective Weil-Being for SOS-10-E by

Personality Traits, Psychological Mindedness and Acculturation 84

8. Multiple Regression Predicting Subjective Weil-Being for PGWBS by Personality

Traits, Psychological Mindedness and Acculturation 85

9. Stepwise Regression Predicting Subjective Well-Being for SOS-10-E by

Acculturation Subscales 89

10. Stepwise Regression Predicting Subjective Well-Being for PGWBS by

Acculturation Subscales 90

11. Multiple Regression Predicting Subjective Well-Being for SOS-10-E by

Personality Traits, Psychological Mindedness and Spanish Language 91

12. Multiple Regression Predicting Subjective Well-Being for PGWBS by

Personality Traits, Psychological Mindedness and Spanish Language 92

13. Summary of Findings 93

Figure

1. Visual Representation of Acculturation Models 45

 vi

ACKNOWLEDGEMENTS

I would first like to thank my mentor, Dr. John Cecero, for his kindness, support, and
guidance throughout this dissertation process. The dissertation experience would have
been a lot more difficult and lengthy without his warmth and encouragement.

Many thanks to my committee members, Dr. Berretty, Dr. McKay, Dr. Rivera-Mindt, Dr.
Vazquez, and Dr. Yip. Thank you for your thoughtful feedback and taking the time to
meet with me when I needed suggestions or assistance in finding answers.

Thank you to Dr. Anderson and Alicia Munoz. Without your assistance, I would still be
collecting participants instead of defending my dissertation.

To the many friends who have shared this process with me, thank you for all your
support, hugs, and shared laughs. This graduate experience was less difficult because of
you. Specifically, Dr. Bradley Brummett, thank you for being the best graduate school
friend I could have ever wished for. Not only did we spend many hours helping each
other with "peer supervision" and trying to figure out the Rorschach together, but you
were also integral in helping me figure out the last pieces of my dissertation. Thank you
for being such a supportive friend and colleague.

To Talia Marmon, I can't begin to express how much I have appreciated having a
dissertation buddy during this last phase of writing. Thank you for your ear, your
suggestions and your support.

Lastly, Kalila Borghini, you have played a silent role throughout my graduate education.
Thank you for helping me figure things out and for encouraging me when I needed it
most.
 CHAPTER I: INTRODUCTION

Thesis

According to the United States Bureau of Census (2005), Latinos represent 14.4%

of the total United States population and have become the largest ethnic group in the U.S.

Ethical and conceptual reasons exist to support further research with ethnic minority

groups given diverse cultures have variations that require modifications of psychotherapy

interventions (Moodley, 2006; Nagayama Hall, 2001; Preciado, 1999; Sciarra &

Ponterotto, 1991). However, Latinos continue to be underrepresented in research

(DeNeve & Cooper, 1998; Organista, Munoz, & Gonzalez, 1994). The existing

knowledge gap regarding mental health predictors must be filled as quickly as possible to

better serve this growing segment of the population. Therapists should be aware that

Latinos have specific needs, coping skills, and sources of strength in order to tailor

psychological care (Curtis, 1990; Moodley & Palmer, 2006; Patel, 1998; Preciado, 1999).

For example, knowledge of the individual's acculturation level could be a useful tool in

developing culturally sensitive therapeutic interventions (Ponterotto, 1987). Armed with

culturally specific knowledge, professionals might foster higher rates of retention with

new Latino patients and provide treatment with higher effectiveness rates (Acosta, 1979;

Hess & Street, 1991; Folsom et al. 2007; Levine & Padilla, 1980; Moodley, 2006;

Organista, Munoz, & Gonzalez, 1994; Parron, 1982; Ponce & Atkinson, 1989).

A psychosocial outcome variable studied in mental health research is subjective

well-being (Perczek et al. 2000). Research into subjective well-being (SWB) has

proliferated in recent years, in part as a reaction to the emphasis of psychology on

negative states and experiences (Diener et al. 1999). There is no single definition of

1
 2

subjective well-being. Traditionally, SWB involves a cognitive component in which the

individual evaluates a certain situation and assigns a value judgment to it, as well as an

affective component of both positive and negative affect (Feist et al. 1995; Okun, Stock,

& Covey, 1982). For example, if an individual recently lost her/his employment, s/he

will evaluate this as either a positive or negative event and then identify a positive or

negative emotion s/he experiences as a result. Many theorists include constructs such as

experienced emotions, satisfaction with life's circumstances and a general judgment of

life satisfaction as part of SWB (Diener et al. 1999). SWB is a meaningful outcome

variable commonly assessed through the use of self report measures of related constructs,

such as happiness and life satisfaction; personality qualities, such as vulnerability and

resilience factors; or the absence of unpleasant symptoms such as stress, depression and

anxiety (Carrillo et al. 2001; Perczek et al. 2000; Sandvik et al. 1993).

The literature has suggested that multiple variables determine and predict

subjective well-being (Diener et al. 1999; Feist et al. 1995; Okun, Stock, & Covey, 1982).

Both social and psychological constructs have been found to play a role in determining a

person's SWB, such as socioeconomic status (Lang et al. 1982), immigration status

(Rogler, Malgady, & Rodriguez, 1989), self-esteem (Krause, Bennett, & Van Tran,

1989), resiliency (Abraido-Lanza, 1997; Costa & McCrae, 1993; Perczek et al. 2000;

Ryff, 1989), and personality (Costa & McCrae, 1993). Early research has focused on

demographic variables as predictors of SWB (Andrews & Withey, 1976; Campbell,

Converse, & Rodgers, 1976), yet their low predictive value led researchers to shift

attention to uncovering other more salient predictors of SWB, such as personality traits.
 3

The Five Factor Model (FFM), a broad organization of personality traits in terms

of five basic dimensions, predicted subjective well-being in many samples, such as

Spaniards, Filipinos, Germans and European Americans (Benet-Martinez & John, 1998;

Katigbak et al. 2002; McCrae & Costa, 1991; Schimmack, Diener, & Oishi, 2002).

Schimmack, Diener, & Oishi, (2002) propose that personality is more strongly related to

the affective than the cognitive component of SWB. In other words, personality traits are

related more to what the individual experiences emotionally, than to how the person

evaluates or judges her/his emotional experience. Although personality factors have been

related to SWB, they do not explain all of the variance. In order to identify the unique

contribution to SWB, beyond general personality style, two specific variables that

measure internal (psychological) and external (social) influences on subjective well-being

may be Psychological Mindedness and Acculturation level.

While little research has been conducted that evaluates how psychological

mindedness (PM) relates to a person's SWB as defined by Diener et al. (1999), PM has

been positively linked to, but not redundant with, attachment security (Beitel & Cecero,

2003), self-consciousness (Trudeau & Reich, 1995), low Neuroticism, high Openness to

Experience (Beitel & Cecero, 2003), and cognitive flexibility (Beitel, Ferrer, & Cecero,

2004), which are arguably related to SWB. Therefore, research is needed that examines

explicitly the proposed links between SWB and PM.

Research with SWB has mainly focused on non-Hispanic Whites and ignored

Latinos, or tended to include only a small number of Latinos in their samples despite

projected growth in population (DeNeve & Cooper, 1998; Murguia, 2002; Nagayama

Hall, 2001; Sue, 1999). There is a dearth of research literature specific to Latino and
Latina samples (Abraido-Lanzo, 1997; Lazzari, Ford, & Haughey, 1996; Nagayama Hall,

2001; Ryff, 1989). Further, much of the SWB research that has focused on Latinos has

been conducted on samples that are not representative of the diverse Latino population.

For example, the existing SWB research samples include older Latinos or Latinos from

only specific countries of origin such as Colombian immigrants or Mexican descendents

(Janson & Mueller, 1983; Levin et al. 1996; Liang et al. 1988; Markides & Lee, 1990;

Meluk, 2002; Tran, 1995; Tran & Williams, 1994). To allow generalized research

findings, researchers need to expand their samples to include not only older individuals,

but young and middle aged Latinos from diverse Latino countries. There is some

evidence that Latinas experience higher levels of distress than Latinos (Salgado de

Snyder, Cervantes, & Padilla, 1990), while some studies have found no gender

differences (Murguia, 2002). It is crucial that findings be replicated, inconsistencies be

clarified, and that issues specific to this population be identified.

The question regarding what variables beyond personality factors influence SWB

remains unresolved. Nagayama Hall (2001) proposes that culture and ethnicity mediate

an individual's physical health and psychopathology. One variable that differentiates

individuals within minority groups is the process of acculturation. While the process of

acculturation has been cited as a source of distress (Funk, 1993; Moritsugu & Sue, 1983;

Pearlin, 1989; Rogler, Cortes, & Malgady, 1991), it might be easier for individuals whose

values are similar to those of the United States, who are educated, and who speak English

(Rogler, Cortes, & Malgady, 1991). The limited research available is unclear regarding

the role that acculturation plays in a person's subjective well-being (Cuellar and Roberts,

1997; Golding and Burnam, 1990; Kaplan & Marks, 1990, Krause, Bennett, & Van Tran,
1989; Rogler, Cortes, & Malgady, 1991; Salgado de Snyder, 1987). Consequently, no

comparison model exists that evaluates the relationship between Acculturation, PM and

FFM on subjective well-being. Even further, it is unknown if any one or a combination of

these independent variables can predict SWB for specific populations, such as Latinos

and Latinas. This study sought to increase the knowledge base for this underrepresented

group and confirm the degree to which previous research results are generalizable.

This literature review begins by presenting a justification for ethnically focused

research. A review of relevant theoretical and empirical literature for SWB, FFM, PM,

and Acculturation will ensue. Each construct will be defined, its theoretical foundation

discussed, and mode of operation for each will be explored. Once the history and

operational methods are presented for each construct, a review of research linking SWB

to each respective construct (i.e., FFM, PM and Acculturation) will follow. This review

will focus mainly upon research conducted with Latino and Latina samples. Finally, the

areas of weakness within the available literature will be reviewed and justification for the

present study will be presented.

Literature Review

Rationale for Culturally Specific Research

"Hispanic" is an umbrella label that refers to individuals of Spanish origin who

share the same language (Murguia, 2002). The term Hispanic and Latino are often used

interchangeably to include individuals from North America (United States and Mexico),

Caribbean Islands (i.e., Puerto Rico, Dominican Republic and Cuba), Central America,

and South American. The use of Hispanic to categorize this large and diverse group of

people has led to confusion and discontent among many who are included in this group.
Many individuals from these countries who are second and third generation in the United

States do not speak Spanish. Some populations of Latin American descent, such as

Brazilians, embrace a nationality that does not have ties to Spain or the Spanish language

(Murguia, 2002). Due to these and many other concerns, many individuals prefer to use

Latino as a self-referent identifier (Sue & Sue, 1999). Given this preference, this study

will refer to individuals who are traditionally labeled Hispanic, as Latinos.

Immigration from international countries represented approximately 40% of the

United States population growth from 1990 to 2000 (Zea et al. 2003). According to the

United States Bureau of Census (2004), Latinos represent 12.5% of the total United

States population, with 36% of those Latinos being foreign born and 43% having arrived

in the U.S. within the past decade. According to census information, Latinos have

become the largest ethnic group in the U.S. (Guzman, 2001). The United States Bureau

of Census further estimates that between the year 2000 and 2020, Latinos will comprise

44% of the nation's population. This Latino population surge is attributed to high

fertility, immigration rates and low mortality rates (Therrien & Ramirez, 2001).

Some epidemiological and personality studies report few ethnic differences exist

regarding psychopathology (Hall, Bansal, & Lopez, 1999; Kessler et al. 1994; Nagayama

Hall, 2001). The notion that psychopathology is experienced similarly by different ethnic

groups might not be accurate, as a weakness of these comparative studies is the use of

measures developed with a basis in European American culture. This focus does not

allow for detection of culturally specific phenomenon (Mumford, 1993). Finding cultural

differences is unlikely, unless these studies specifically seek to identify variations and use

culturally sensitive measures and relevant constructs (Betancourt & Lopez, 1993; Lewis-
 7

Fernandez & Kleinman, 1994; Nagayama Hall, 2001). For example, using specific

symptoms and terms used by different cultures, such as "ataques de nervios" among

Latino populations would help in the detection of culturally relevant constructs. Unlike

studies that have primarily European American samples, studies that have specifically

focused on minority group members have found a higher incidence of psychological

disorders, such as Major Depressive Disorder (MDD) (Burnam et al. 1987; Rogler,

Cortes, & Malgady, 1991), anxiety disorders (Karno et al. 1989), and alcohol abuse

(Rogler, Cortes & Malgady, 1991).

Importantly, psychotherapeutic interventions that were developed for and by

middle-class European Americans might not be appropriate for all ethnic minority

individuals. These therapeutic interventions might be most appropriate for ethnic

minority members who are similar to middle-class European Americans. Specifically,

ethnic minority individuals who are "acculturated, speak English, are educated, are not

socioeconomically disadvantaged, are not strongly identified with ethnic minority

cultures, and have not experienced much discrimination and disenfranchisement"

(Nagayama Hall, 2001, pp 5). Acculturation and its measurement have been identified as

useful to therapists in conceptualizing the needs of their ethnic minority clients (Atkinson

et al. 1998; Curtis, 1990; Hess & Street, 1991; Kim & Abreu, 2001; Ponce & Atkinson,

1989). Atkinson et al. (1998) reviewed the research examining the relationship between

acculturation and counseling and proposed that

these studies provide consistent documentation that acculturation is related

to how racial/ethnic minority clients perceive and respond to counseling
services. In general, they suggest that less acculturated racial/ethnic
minorities are more likely to trust and express a preference for and a
willingness to see an ethnically similar counselor than their more
acculturated counterparts.. .Counselors working with an ethnic minority
 8

client should be aware not only of the client's ethnic background but the
extent to which the client identifies with and practices the culture of
his/her ancestors, (p. 31)

This review suggests that acculturation level could influence therapeutic compliance,

outcome, and potentially symptom severity. In order to provide more clarity to this issue,

identifying the role acculturation plays in predicting SWB is beneficial and potentially

essential when working therapeutically with individuals of varying acculturation levels

(Kim &Abreu, 2001).

It should be noted that studies have found that women report higher levels of

stress and psychological distress, which could influence subjective well-being (Hovey,

2000; Salgado de Snyder,Cervantes, & Padilla, 1990; Perez, 1998; Rogler, Cortes, &

Malgady, 1991). For example, Hovey (2002) assessed the depression levels of 114

Mexican immigrants (76 female, 38 male) using a measure of depressive symptoms

(CES-D) and found that women reported a significantly higher number of depressive

symptoms when compared to men ( F ( l , 107) = 4.19,/? < .05). Yet, no gender

differences in psychological well-being reports were noted in some studies that included

both Latinos and Latinas (Meluk, 2002; Murguia, 2002). Meluk (2002) conducted a

study with 106 Colombian immigrant males and females, while Murguia (2002)

conducted a study with 247 female and male participants of Mexican descent. Both

studies did not find gender differences in life stressors or well-being. Given the mixed

results in the literature regarding gender differences in SWB, this study will focus on

predictors of SWB in both Latinos and Latinas.

 9

Subjective Weil-Being

Research often uses both subjective and psychological well-being (PWB)

interchangeably (Headey, Kelley, & Wearing, 1993). This has resulted in confusion

within the literature and limitations to result interpretation. Some believe these terms are

part of the same construct and therefore can be used interchangeably. Subjective well-

being researchers go on to propose a number of S WB models or theories without making

any distinctions between the two terms (DeNeve & Cooper, 1998; Diener et al. 1999),

while others propose that both are distinct variables that tap different experiences (Keyes,

Shmotkin, & Ryff, 2002).

SWB has been operationalized as happiness and life satisfaction, and the absence

of psychiatric distress symptoms such as stress, depression and anxiety (Carrillo et al.

2001; Perczek et al. 2000; Sandvik, Diener, & Seidlitz, 1993). Measures such as

physiological measures and daily diary reports have also been used to assess SWB (for

review see Schwarz & Strack, 1991). The physiological measures and daily diary reports

were implemented in order to reduce the possible effect that a participant's present mood

could have on the perception and recall of retrospective SWB, such as the SWB

experienced in the last month.

In the 1950s, SWB was used as a way to index quality of life and monitor social

change (Keyes, Shmotkin, & Ryff, 2002). Initially, SWB and happiness were used

synonymously by researchers (Diener, 1984; Murguia, 2002). A review of the first

literature correlated happiness with multiple variables, such as youth, health, education,

religion, marriage, high self-esteem, job morale, optimism and extraversion (Wilson,

1967). Early research focused on demographic variables, yet these external factors
 10

accounted for only 8% to 20% of the variance for SWB (Andrews & Withey, 1976;

Campbell, Converse, & Rodgers, 1976). As research evolved, an exploration of the

underlying processes of SWB became the focus. Researchers began to recognize an

interaction between external factors and certain internal factors such as goals, coping

efforts, and dispositions (Diener et al. 1999).

Despite the multiple definitions proposed for SWB, there is a conceptual

consensus that it is a multidimensional concept (Murguia, 2002). Some see SWB as the

balance of the body and mind (Padilla & Salgado de Snyder, 1988). One definition

proposed within the literature conceptualizes SWB as a higher order factor that

incorporates distinct but correlated psychological aspects that include emotional

responses, contentment regarding specific life situations, and global judgments of life

satisfaction (Stones & Kozma, 1985 as cited in Diener et al. 1999). In other words, SWB

involves both positive and negative affect, such as whether the individual is either

emotionally happy or unhappy. SWB also involves a cognitive evaluation of a specific

time, event, or life experience, such as a judgment of whether the individual is happy or

unhappy regarding a life experience (Feist et al. 1995; Okun, Stock, & Covey, 1982;

Schimmack, Diener, & Oishi, 2002; Watson & Tellegen, 1985). The appraisal of life

circumstances and events then influences the experience of positive or negative affect

(Myers & Diener, 1995).

Individuals in a similar situation will report different levels of SWB (Michalos,

1985; Myers & Diener, 1995). This is believed to be due in part to the fact that people

adapt and cognitively evaluate a situation differently. Michalos (1985) proposed that

individuals experience higher level of satisfaction with their lives by comparing the
 11

difference between what their ideal condition would be and what their current condition

presently is. They report increased satisfaction if their current situation was better than

their expected ideal situation. Myers and Diener (1995) propose that the global sense of

life satisfaction derives from the individual's perception of whether aspirations are met.

In addition to a cognitive component, SWB is thought to include an affective

component, a balance between positive and negative affect (Schimmack, Diener, &

Oishi, 2002; Watson & Tellegen, 1985). Subjective well-being researchers link positive

affect to positive emotions and pleasure, while linking negative affect to negative

emotions and pain. It is reasonable to hypothesize that individuals report higher levels of

well-being to some extent when they experience more pleasure and less pain.

Lyubomirsky, King and Diener (2005) report that positive affect characteristics include

confidence, optimism, physical well-being, effective stress coping mechanisms, and

flexibility. While negative affect characteristics would include pessimism, anxiety, and

depressive symptoms (Measelle, Stice, & Springer, 2006). Research within the last

decade has found that positive and negative affect are not opposites, but instead are

independent dimensions that impact life satisfaction and happiness (Diener & Emmons,

1984; Green, Goldman, & Salovey, 1993; Keyes, 2000). For the purposes of this study,

SWB will be defined as incorporating both an affective and cognitive component.

Theoretical Predictors of Subjective Weil-Being

Different theories of SWB exist. Costa and McCrae (1980, 1984) propose that

personality alone can predict SWB. Yet, despite personality traits being highly stable,

SWB is only moderately stable over time (Headey & Wearing, 1989; Holmstrom &

Wearing, 1985). A second SWB theory is the Adaptation Level Theory, which proposes
 12

that despite adverse life events an individual's SWB remains constant or quickly returns

to a pre-adverse event level (Brickman et al. 1978). Limited research has been conducted

to support this theory. Alternatively, the Top Down Theory of SWB is linked to the

individual's personality and proposes that SWB is a global tendency to experience life in

a negative or positive manner (Diener, 1984). The stressor or life event is irrelevant, as

the person's reported SWB remains consistent. Again, limited research has been

conducted to support this theory.

This study used the Dynamic Equilibrium Model (DEM) to guide its predictions.

The DEM of SWB is a combination of adaptation and personality theories, in which an

individual has a personal baseline of positive and negative affect to which they return to

after stressful events (Headey & Wearing, 1989). Headey and Wearing (1989) developed

the DEM based on results from a 6 year longitudinal study in which they found that 649

participants reported stable SWB levels throughout the four time points studied between

1981 and 1987. Based on these results they proposed that the individual's personality

helps them strive to return to a normal SWB equilibrium level. Headey and Wearing

(1989) propose that life experiences are endogenous, or internally driven, not simply

experienced as exogenous, or external, events. The stable personality traits (Neuroticism,

Extraversion and Openness to Experience) of the individual drives them to engage in

behaviors that predispose them to experience positive and/or negative exogenous events

(Ormel & Wohlfarth, 1991). These adverse positive or negative life events influence

SWB over and above the effect of personality alone. Then the individual's personality

sets the standard by which recent adverse events are compared in order to determine their

momentary changes in SWB and brings them back to their normal equilibrium level.
 13

Well-Being and Latinos

Limited literature exists that focuses on identifying the level of SWB in a Latino

sample. Diener and Diener (1996) suggest that people have a positive equilibrium

baseline level, and that most individuals reported themselves as "happy" or "neutral."

They reviewed almost 1,000 international studies of SWB, defined as happiness,

neutrality or life satisfaction. Diener and Diener (1996) reported that 41 out of 43 nations

with available SWB survey data, including less westernized nations such as Brazil and

Mexico, endorsed above neutral affect. Only India and the Dominican Republic endorsed

below neutral affect. The "happiness or satisfaction" international mean was 6.33, on a

scale of 0 being "most unhappy" and 10 being "most happy." It is argued that individuals

are typically "mildly happy" (Diener, Fujita, & Sandvik, 1994).

Oishi et al. (2004) conducted a recent cross-cultural and cross-situational study of

SWB consistency, defined by positive and negative affect. The sample included 68

Hispanic American students that reported speaking "only Spanish at home," 80 Japanese

students attending Japanese universities, 131 Indian students attending multiple

universities in India, and an American sample consisting of 92 ethnically diverse students

in Illinois, of which 4 participants were Latino. The participants were asked to report

their mood when an alarm from a hand held computer rang periodically throughout a 7-

day period. Oishi et al. (2004) found that all participant groups reported consistent

positive or negative affect, independent of the situation they were in, when prompted to

report their SWB. There were no differences between the different cultural groups in

their reported negative affect. Significant differences in reported positive affect were

noted between the Hispanic sample and the Americans from an Illinois sample in
 14

situations when alone or with friends. When in family situations, no gender or cultural

differences in positive affect were reported.

Scollon et al. (2005) conducted a study of "pleasant" and "unpleasant" emotions

with a sample of 386 subjects comprised of 46 European American, 33 Asian American,

81 Hispanic, 94 Japanese and 61 Indian students. These students reported their affect 7

times a day for one week at random times throughout the waking hours. There were little

cross-cultural differences noted of reported pleasant and unpleasant affect. In a study

comprised of only Latinas, Lazzari et al. (1996) completed a qualitative study of 21

Latinas, 20 of whom identified as Mexican-American. They found that Latinas who

reported serving or contributing to their community reported higher personal well-being.

In another study, Abraido-Lanza (1997) sought to identify if cultural strengths influenced

coping among 109 Latinas with arthritis, none of which were of Mexican descent. These

Latinas reported higher self-esteem if they were employed and were mothers. More

research has been conducted that specifically evaluates the role acculturation plays in

Latino's SWB, and this literature will be reviewed in the acculturation section.

Five Factor Model of Personality

According to Goldberg (1995), the Five Factor Model (FFM) is the most

comprehensive and parsimonious model of phenotypic personality descriptors presently

available. The evidence for its utility is arguably more voluminous and more compelling

than for any other such model. The FFM of personality, also known as The Big Five, is a

broad organization of personality traits in terms of five basic dimensions: Extraversion

(E), Agreeableness (A), Conscientiousness (C), Neuroticism (N) and Openness to

Experience (O) (McCrae & John, 1992). Personality traits can be defined as "dimensions
 15

of individual differences in tendencies to show consistent patterns of thoughts, feelings,

and actions" (Costa & McCrae, 1990, p. 23). It is argued that all humans fall within a

range of each of the five factors and all individual's personalities are made up by these

basic traits.

The traits are measured on a spectrum (Costa & McCrae, 1990). The E factor

ranges from extraversion to introversion, or quantity and intensity of interpersonal

interaction. The A factor is agreeableness to antagonism, or quality of one's

interpersonal orientation-compassion. The C factor includes conscientiousness to lack of

direction, or degree of organization, persistence and motivation in goal directed behavior.

The N factor consists of neuroticism to emotional stability, or adjustment versus

emotional instability. Finally, the O factor comprises openness to new experiences to

being closed, or proactive seeking and appreciation of experience, tolerance and

exploration of the unfamiliar.

Evolution of the Five Factor Model of Personality

There are two major approaches to account for the comprehensiveness of the

model. The first was based on the lexical hypothesis (Allport & Odbert, 1936). Since it

is believed that the most important and common human traits have been identified in all

cultures, researchers looked through word dictionaries. It was an analysis of such traits

that the five-factor model was first identified.

For decades, researchers in factor analysis have sought to summarize the list of

traits by identifying underlying dimensions. Various theorists proposed that as few as

three factors (Eysenck, 1967) and as many as sixteen factors (Cattell, 1966) accounted for

personality variance (Allport & Odbert, 1936). More recent research using a more
 16

representative selection of trait terms has confirmed that the five factors are both

necessary and sufficient to account for the covariation among these terms (Goldberg,

1990; Tupes & Christal, 1961/1992).

The second approach was more haphazard: scales and inventories created by

personality psychologists were analyzed to identify common factors. The NEO

Personality Inventory-Revised (NEO-PI-R) was developed as a questionnaire measure of

the FFM. Studies comparing NEO-PI-R scales to those found in a variety of standard

personality questionnaires suggested that the same five factors found in natural language

were also the basic dimensions underlying personality questionnaires (McCrae, 1989).

There is now ample evidence that the dimensions of the five factor model refers to

observable differences in patterns of thought, feeling, and behavior.

Where reliable and valid instruments were used, the correspondence between the

five factors was found to be substantial. McCrae and Costa (1989) reported self/peer,

spouse/peer, and peer/peer correlations from .26 to .54 for the five factors of the NEO-PI-

R; agreement between self and spouse was even higher (r(54) = .39 to .53). They propose

that the five factors can be collaborated by others and therefore the factors themselves

refer to real, consensually validated aspects of human behavior that can be treated

quantitatively.

Correlations between the NEO-PI-R and well established personality

questionnaires, such as the Minnesota Multiphasic Personality Inventory Depression

Scale (MMPI-D) (Dahlstrom, & Welsh, 1960) and the Millon Clinical Multiaxial

Inventories, have been found and replicated (Costa & McCrae, 1990; Wiggins & Pincus,

1989). Since the personality measures based on different theories are correlated, it
 17

implies that the Big Five correlates with other personality theories. Once correlated to

other personality theories, FFM required cross cultural and cross lingual validation.

Good to excellent replications in either the natural language or questionnaire measures

have been reported for Spanish, German, Dutch, Japanese, Filipino, and Chinese samples

(Benet-Martinez & John, 1998; Katigbak et al. 2002). The FFM has also been found in

children, college students, older adults, women and men, in non-Hispanic White as well

as ethnic minority respondents.

Limitations to the Five Factor Model have been noted that include, "the model's

inability to address core constructs of personality functioning beyond the level of traits,

and reliance on simple, noncontingent, and implicitly comparative statements about

persons" (McAdams, 1992, pp. 329). Despite this criticism, the FFM is one of the most

widely accepted and researched personality models. Evidence continues to confirm that

the dimensions of the five factor model refers to real and observable personality

variations of thought, feeling, and behavior (Bouchard, Lykken, & McGue, 1990; Gifford

& O'Connor, 1987; Small, Zeldin, & Savin-Williams, 1983).

Five Factor Model of Personality and Well-being

People are resilient and quickly adapt to life situations. As a result, variables such

as physical health, age, marital and socioeconomic status do not permanently alter well-

being (McCrae & Costa, 1991; DeNeve & Cooper, 1998). Well-being measures

incorporate present level of functioning, yet people's level of well-being tends to show

stability across time (Costa, McCrae, & Zonderman, 1987; Headey & Wearing, 1989;

Ormel & Wohlfarth, 1991; Schimmack, Diener, & Oishi, 2002). Research shows that

individuals tend to consistently experience life events in either positive or negative ways
 18

(Diener, 1984). The level of SWB leads to satisfaction reports in other areas of life, such

as work satisfaction, physical health and assumptions about the world (DeNeve &

Cooper, 1998; Headey, Veenhoven & Wearing, 1991).

Given that demographic and social variables had a small predictive value for

SWB (Andrews & Withey, 1976; Campbell, Converse, & Rodgers, 1976; Wilson, 1967),

researchers turned their attention to more intrinsic or lasting variables such as personality.

Lucas & Diener (2000) report that personality is one of the most robust and reliable

predictors of SWB. Headey & Wearing (1989) suggest that personality plays an

important role in the global effect of SWB on life experience. They proposed the

Dynamic Model of Equilibrium, utilized within this study, where every individual has a

"normal equilibrium level of SWB" that is maintained by personality characteristics.

Most important to helping return SWB to a normal equilibrium level for each

individual are the traits of high levels of Extraversion, low Neuroticism (Ormel &

Wohlfarth, 1991; Schimmack, Diener, & Oishi, 2002), and high Openness to Experience

(Headey & Wearing, 1989). Ormel and Wohlfarth (1991) conducted a 7-year

longitudinal study with 296 participants (157 male, 139 female) from the general

population. The participants were interviewed at three different time-points during a 7-

year period and they found that Neuroticism was related to and had a direct effect on

reported psychological distress. In a longitudinal study that took place during one

semester with college students in a United Stated University, Schimmack, Diener, &

Oishi, (2002) asked 122 participants (36 males, 86 females) to rate their life satisfaction

using the Satisfaction with Life Scale (Diener et al. 1985). The participant's personality

was initially assessed at the beginning of the semester, while their life satisfaction was
 19

assessed during two time-points, at the beginning of the semester and at the end of the

semester. Schimmack, Diener, & Oishi, (2002) found that the participants' reported life

satisfaction remained consistent between the two time-points assessed and found that

Extraversion positively predicted life satisfaction, while Neuroticism negatively predicted

life satisfaction. In Headey & Wearing's (1989) 6-year longitudinal study of 649

Australians, Openness to Experience was significantly correlated to their three measures

of SWB (Life Satisfaction r = .14, Positive Affect r = .18, and Negative Affect r = .07).

Given these findings, the new direction of SWB and personality research is to identify the

traits most related to SWB, as well as the causal direction and the mechanisms behind

this process.

In recent years research has proliferated in an attempt to understand the role

personality plays in predicting individual's health and subjective well-being (Carrillo et

al. 2001; Compton, 1998; McCrae & Costa, 1991; Robinson et al. 2003). Personality

predisposes individuals to behavior patterns. Their behavior tendencies and patterns then

influence the experiences they engage or avoid, as well as their outcomes (Headey &

Wearing, 1989; Robinson et al. 2003). A meta-analysis of 142 studies evaluated 1,538

correlation coefficients relating 137 personality traits to SWB (DeNeve & Cooper, 1998).

DeNeve and Cooper's (1998) meta-analysis revealed that health, personality and socio-

economic status (SES) are the strongest correlates of SWB. A meta-analysis of 137

SWB studies conducted prior to 1980 found that personality plays a significant role in

health perception (Okun et al. 1984). Studies have found that personality is predictive of

various specific subjective well-being related variables, such as life satisfaction,

happiness, social interest, and positive affect (Compton, 1998; Headey & Wearing, 1989;
Schimmack, Diener, & Oishi, 2002). The relationship between personality and negative

affect has been mixed (DeNeve & Cooper, 1998; Headey & Wearing, 1989; McCrae &

Costa, 1991).

Costa and McCrae (1980; 1991) hypothesized that happiness and the consistent

emotional reactions related to this state could be understood as dispositions or

temperament. They argued that positive affect was correlated to the Extraversion and

negative affect to Neuroticism traits. Multiple studies and reviews have found a

consistent positive correlation between Extraversion and SWB and between Neuroticism

and negative affect (Compton, 1998; Costa & McCrae, 1991; Diener, 1984; Ormel &

Wohlfarth, 1991; Schimmack, Diener, & Oishi, 2002).

Costa and McCrae (1991) explain the relation between Extraversion and SWB as

being mediated by temperament, or an enduring disposition. It is argued that it is not

Extraversion per se, but the fact that extraverts are more outgoing, engage in activities

that promote beneficial outcomes, have a more positive outlook on life, and make more

positive cognitive attributions to events (Robinson et al. 2003). Barrett & Pietromonaco

(1997) found a cognitive relation between Neuroticism and SWB in which individuals

who scored high in Neuroticism also tended to retrospectively overestimate their distress

over a 90-day period. Ormel & Wohlfarth (1991) conducted a longitudinal study that

evaluated 296 Dutch subjects' Neuroticism level, psychological distress, life situation

change and long-term difficulties at three time points over seven years (time 0, time 1-

six years later, time 2- 1 year later). They found that Neuroticism had a stronger effect

on psychological distress than life situation changes and long-term difficulties. Their
 21

findings suggest that medium to high Neuroticism levels, are stronger predictors of

psychological distress than negative environmental factors.

In 1991, Costa and McCrae expanded their hypothesis to incorporate the other

three factors. They proposed that Openness to Experience would be predictive of both

positive and negative affect, as being more open to experiences tends to expose

individuals to feel things more deeply. They predicted that Agreeableness and

Conscientiousness would both increase levels of SWB, as these factors and the traits they

encompass tend to facilitate constructive action in both social and achievement

circumstances. In turn, as achievement of goals are facilitated by Agreeableness and

Conscientiousness, they will be correlated with happiness and life satisfaction.

Results of a meta-analysis support Costa and McCrae's theory of SWB and

temperament. The meta-analysis examined the relationship between SWB and 137

distinct personality traits that were grouped into the FFM (DeNeve & Cooper, 1998). A

predictive relationship was revealed between the Neuroticism factor and life satisfaction,

happiness, and inverse negative affect (DeNeve & Cooper, 1998). They further found

that among the FFM, Neuroticism correlated most with SWB, r= (338)= -.22. McCrae

& Costa (1991) conducted a longitudinal study with a sample of 429 men and women

who completed both self-report and spouse ratings of five factors and psychological well-

being. The correlations between the self and spouse ratings of the NEO-PI ranged from

.53 to .60. McCrae & Costa (1991) report that their findings were consistent with

previous research that has identified Neuroticism as predictive of negative well-being.

The fact that high levels of Neuroticism and Extraversion influence the balance of

affect was replicated by Schimmack, Diener, & Oishi (2002). Additionally, the factors of
 22

Extraversion and Agreeableness both equally predicted positive affect, while

Extraversion most strongly predicted happiness (DeNeve & Cooper, 1998). Costa &

McCrae (1991) report that their findings were consistent with previous research that has

identified Extraversion as predictive of positive well-being.

Keyes, Shmotkin, & Ryff (2002) found a robust predictive relationship between

Conscientiousness and SWB in a national sample of 3,032 Americans ranging in age

from 25 to 74. Results from the meta-analysis mentioned earlier found that among the

FFM, Conscientiousness correlated strongly with SWB (r(334) = -.21) (DeNeve &

Cooper, 1998). McCrae & Costa (1991), found that Agreeableness and

Conscientiousness also significantly predicted psychological well-being, while Openness

to Experience loaded to both positive and negative affect and was not predictive of

psychological well-being.

The limited data exploring the relationship between SWB and Openness to

Experience has found mixed results (McCrae & Costa, 1991). Some studies found that

Openness to Experience does predict psychological adjustment and well-being, while

others have found a weak statistical relationship (Carrillo et al. 2001; Carrillo et al. 1998;

Compton et al. 1996; Costa & McCrae, 1990; Headey & Wearing, 1989). DeNeve and

Cooper (1998) reported Openness to Experience had the weakest correlation to SWB

(r(334) = .11), when broken down it correlated equally with positive affect and life

satisfaction (r(126)= .14) and weakly with negative affect (r(102)= .05). Strong evidence

suggests that the weakest correlation among FFM and SWB is Openness to Experience

(DeNeve & Cooper, 1998; McCrae & Costa, 1991; Keyes, Shmotkin, & Ryff, 2002).

While some have found that Openness to Experience predicts depression, Carrillo et al.
 23

(2001) found that Openness to Experience predicted a lack of depression (R2 = .495; t = -

5.541;/? < .001) among 112 non-clinical participants (50% female).

Based on the Dynamic Equilibrium Model and the documented evidence linking

FFM to SWB, this study will evaluate the predictive relationship between Extraversion,

Neuroticism and Openness to Experience to SWB. Conscientiousness and Agreeableness

will not be evaluated given a majority of studies found their limited contribution to SWB.

Five Factor Model of Personality, Well-being and Culture

Studies have found that personality and culture influence subjective well-being

(DeNeve & Cooper, 1998; Diener & Lucas, 1999). Life satisfaction has been found to

be moderated by culture. Individualistic cultures emphasize independence, freedom of

choice and a focus on emotions; while collectivistic cultures emphasize interdependence

with family and adherence to cultural norms instead of maximizing an individual's

enjoyment or pleasure (Schimmack et al. 2002). The focus of individual enjoyment in an

individualistic culture versus the focus on adhering to cultural norms influences life

satisfaction. Many have studied personality and culture in isolation without taking into

account that an interaction is possible. Certain personality traits, such as Neuroticism and

Extraversion, have been consistent predictors of subjective well-being in a number of

countries and in genetic twin studies (Schimmack et al. 2002). In a cross cultural study

of individualistic (United States, German) and collectivistic countries (Mexico, Japan,

Ghana) with a total of 651 participants (48% female), Schimmack et al. (2002) proposed

a causal model of personality and subjective well-being, where personality was more

strongly related to the affective rather than the cognitive component of well-being. They

hypothesized that the level of extraversion and neuroticism influences how much positive
 24

and negative affect the individual will experience. People in individualistic, rich and

democratic cultures tended to report higher subjective well-being, while individuals in

collectivistic, poor and totalitarian cultures reported lower levels of subjective well-being.

Both Neuroticism and Extraversion influenced the balance of affect. Given the robust

evidence of the FFM cross-culturally, FFM related findings are often generalized to

specific groups without replication within those groups.

Although the cross-cultural validation of FFM and SWB is growing, few studies

have been conducted that focus on the subjective well-being of Latino populations and

the FFM specifically. The above mentioned meta-analysis of personality traits and SWB

illustrates the limited incorporation of Latinos in this field of research (DeNeve &

Cooper, 1998). The total sample of the meta-analysis consisted of 42,171 individuals, yet

only 115 were Latino (0.2% of the sample). The limited number of studies conducted

that used non-English speaking samples was specifically cited as a limitation of this

meta-analysis and SWB research in general.

One study that specifically explored the relationship between FFM and a variable

related to SWB in a Latino population was Carrillo et al. (2001). He and his colleagues

explored the relationship between Openness to Experience and depression on a sample of

112 non-clinical participants of Spanish origin, with equal representation from males and

females. The participants completed the NEO-PI that was translated and validated into

Spanish and the Beck Depression Inventory (BDI). Although the entire NEO-PI was

completed, only the Openness factor was examined in this study. Openness to

Experience was further broken down into Openness to fantasy and Openness to action.

The general finding was that these two facets of openness have different predictive paths.
 25

Openness to action was strongly predictive of S WB and adaptive to psychological health.

Those high in Openness to action were less likely to be depressed, while high scores in

Openness to fantasy predicted depression. Openness to action was common in both

genders, while Openness to fantasy was more common among women. A flaw of this

study is that SWB is defined in terms of presence or absence of depressive symptoms.

Despite this limitation, it is an important study, as it provides further cross cultural

application and validation of the FFM.

When personality accounts for approximately 50% of the SWB variance, the

question remains as to what other variables account for the remaining 50% (Bergeman et

al. 1993; Bouchard, Lykken, & McGue, 1990; Diener & Lucas, 1999; Diener et al. 1999;

Tellegen et al. 1988). The present study sought to add to this body of research by

examining the predictive relationship of psychological mindedness and acculturation to

SWB.

Psychological Mindedness

Psychological mindedness (PM) is defined as a multidimensional construct that

involves a motivation to engage in cognitive reflection and evaluation of self and other's

behavior. PM is widely accepted by psychologists as an important ability and positive

attribute for patients treated in dynamically oriented psychotherapy (Conte, Ratto, &

Karasu, 1996; McCallum & Piper, 1997). Some believe that PM is required before

beginning therapy and predictive of positive outcome (Piper et al. 2001). The literature

considers it synonymous with insight, introspection and self-awareness. PM involves

being interested in and appreciative of patterns and behavioral repetitions between

personal and interpersonal interactions, and being analytical of the interplay between
affect, behavior and cognitions of self and others (Beitel, Ferrer, & Cecero, 2004;

Werman, 1979). PM has been described as a stable characteristic and linked to

personality traits (Beitel & Cecero, 2004; Conte, 1990; Conte et al. 1995; Kerckhoff,

1981; Piper et al. 2001; Trudeau & Reich, 1995).

Theoretical Foundation of Psychological Mindedness

A review of the PM theoretical and empirical literature follows. Table 1

summarizes the myriad overlapping definitions of PM exist in the literature. This lack of

a clear definition has led to problems in consistency within research as it allows

researchers to pick and choose different aspects of the construct and measures (Hall,

1992).

For instance, Appelbaum (1973) defines PM as "a person's ability to see

relationships among [his] thoughts, feelings, and actions, with the goal of learning the

meanings and causes of his experiences and behaviour." This definition contains three

elements: "interest in the way minds work, capacity for concern about self and others,

and ability to allow affects their rightful place (Appelbaum, 1973)." Appelbaum

conceptualizes PM as a process, and differentiates insight as the product of this process.

He further qualified that the individual must have the verbal ability and the capacity to

think abstractly and integrate information. Another quality that a psychologically minded

individual must possess is the ability to tolerate anxiety and other affect, tempered by the

belief that the unknown will become known. Appelbaum proposed that the purpose of

psychological defenses was to narrow down "cognitive and emotional awareness."

 27

Table 1

Definitions of Psychological Mindedness

Author(s) Definition(s)

Conte & Ratto An ability to be introspective about one's own feelings, thoughts
and behavior as well as an interest in understanding why others
feel, think, and behave as they do.

Hatcher & Hatcher The capacity to achieve psychological understanding of oneself

and others, a complex capacity, built on both cognitive and
emotional skills.

Farber & Golden The tendency to look for motives, patterns, and distortions in
oneself and others, a trait, consisting of both an affective and an
intellectual component.

McCallum & Piper The ability to identify dynamic (intrapsychic) components and to
relate them to a person's difficulties.

Dollinger The ability to read between the lines of what a person does or says.
The ability to search beneath the surface of human behavior as
well as the interest to do so.

Hall * Accurate psychological-mindedness is displayed by an individual

to the extent that he or she displays both the interest in and ability
for reflectivity about psychological processes, relationships, and
meanings, and across both affective and intellectual dimensions.

Notes: All but Hall definition adapted from McCallum & Piper (1997), Psychological
Mindedness: A Contemporary Understanding (pp. 238-239). Mahwah, New Jersey:
Lawrence Erlbaum Associates, Inc.
* Adapted from Hall, J. A. (1992). Psychological Mindedness: A conceptual model.
American Journal of Psychotherapy, XLVI(l), 131-140.

With regards to personality, Appelbaum did not believe that PM was a quality that

could be trained, as he felt it was dependent upon constitutional or early developmental

structures (Appelbaum, 1973). Appelbaum uses PM to justify beginning therapy. He

further argued that patients with low PM required that the therapists modify their
 28

treatment by requiring more active participation in the treatment in order to minimize the

patient's deficit (Appelbaum, 1973).

Similar to Appelbaum, McCallum and Piper (1997) define PM as the "ability to

identify dynamic (intrapsychic) components and to relate them to a person's difficulties."

They conceptualized PM as being a hierarchical organization of assumptions, and

proposed nine levels of psychological mindedness (Refer to Table 2).

Table 2

The Nine Levels of Psychological Mindedness

Level Assumption

1 Identification of a specific internal experience of another person (the

target).

2 Recognition of the driving force of an internal experience of the target.

3 Identification of a result of a drive such that a causal link is made between

an internal event and its resultant expression.

4 Recognition that the motivating force in the target is largely out of

awareness or is unconscious.

5 Identification of conflictual components of the target's experience.

6 Identification of a causal link where the conflict is presented as generating

an expression.

7 Identification of a causal link where tension (fear, anxiety) is presented as

motivating an expression.

8 Recognition that the target is engaging in a defensive maneuver.

9 Recognition that despite the defensive maneuver, the target remains

disturbed in some way by the conflict.
Note: Adapted from McCallum & Piper (1997), Psychological Mindedness: A
Contemporary Understanding (pp. 33). Mahwah, New Jersey: Lawrence Erlbaum
Associates, Inc.
 The first three levels reflect a belief that all human functioning is derived from an

internal or psychic process. The middle levels (5 through 7) focus on the idea that

conflict creates tensions that must be resolved. The highest levels (8 and 9) indicate the

idea that defenses are activated by conflict (McCallum & Piper, 1997). They see PM as a

means to an end that is helpful for those interested in therapy. McCallum and Piper

(1997) do not believe being psychologically minded implies psychological health, as

even those with severe mental illnesses can be psychologically minded. Studies support

this notion as research has not found a correlation between PM and pre-therapy

psychopathology.

Hall (1992) conceives of PM as two-dimensional, an interplay between

"ability/interest and intellect/affect." She defined PM as a reflection upon psychological

processes, relationships, and meanings that involved both an intellectual and affective

component. Accurate PM is limited if either one of the two components are not present or

impaired. If the individual cannot recognize and label feelings, s/he cannot understand

them intellectually. Therefore, she saw PM as something that is needed for

psychoanalysis.

Hall argues that intellect and affect are both influenced by interest and that

accurate intellect is influenced in turn by affect. She proposes that variables of general

intelligence limit the possible intellectual PM, and further that tolerance for different

feelings limits affective PM. Hall places an emphasis on not only being psychologically

minded, but being accurate with regards to your interpretations. She agrees with others

that PM could be used as a defense against strong affect by engaging in

intellectualization, rationalization, and denial.

 30

Farber (1989) defined psychological mindedness as "a trait, which has at its core

the disposition to reflect upon the meaning and motivation of behavior, thoughts, and

feelings of oneself and others. He conceptualizes PM as a disposition towards

contemplation of psychological phenomenon instead of an ability. He argued that PM is

both experiential, or affective, and intellectual. This intellectual and emotional awareness

of different aspects of life can be both positive and negative. The individual's awareness

can make her/him more attuned and aware of unpleasant and undesirable aspects of

oneself that are difficult to change or potential in oneself that cannot be attained (Farber,

1989).

Conte & Ratto (1997) proposed a new and broader definition based on the PM

Scale:

PM is an attribute of an individual that presupposes a degree of access to one's

feelings, a willingness to try to understand oneself and others, a belief in the
benefit of discussing one's problems, an interest in the meaning and motivation of
one's own and others' thoughts, feelings, and behavior, and a capacity for change
(pp. 21).

Conte et al. (1990) described PM as a method of meaning making by individuals.

Conte's definition of PM and her measure are compatible with the definitions proposed

by Appelbaum (1973), Farber (1989), and Hall (1992).

Dollinger, Greening, and Tylenda (1985) defined psychological mindedness as an

ability to "read between the lines." Like Hall (1992), Dollinger argues that not only

must there be an ability, but also an interest in penetrating self protective defenses with

the goal of insight and understanding of behavior (Dollinger in McCullum & Piper,

1997). This ability appears inborn or a disposition, as he argues that the individual is not

specifically trained, yet is able to know what to look for. Dollinger conducted studies
 31

with children Grades 5 through 12 and found that characteristics of psychological

mindedness can already be traced at a young age, and differing levels of psychological

mindedness can be seen based on answers to seven questions that exemplified different

defenses. The findings included "a) defense understanding was related to age and to

verbal memory, b) some defenses, notably displacement, were more easily "seen

through" by the children, and c) most importantly, good perspective-takers were better at

seeing through defenses than were their more egocentric peers (Dollinger in McCullum &

Piper, 1997)." He finds that good reasoning is required for judgment making, and that

the knowledge of what to look for is required in order to make judgments.

Hatcher and Hatcher (1997) see PM as a complex cognitive ability that is

fundamental to insight oriented psychotherapy. It entails the ability to think

psychologically about oneself, others and about the relationship one shares with others

(Hatcher & Hatcher in McCallum & Piper, 1997). Their PM work focused on children

and adolescents and conceptualized PM as a set of skills that is acquired during a certain

stage of development. They note that many researchers believe aspects of PM are

genetically predetermined and fostered through social interactions.

Interestingly, a number of researchers argued that PM could be used as a defense

by highly articulate individuals (Fogel, 1994; McCullum & Piper, 1997). These

individuals might use PM to ward off knowledge of primitive conflict and areas in their

personality that are not integrated. PM could be both a positive and negative mechanism.

PM could help an individual understand herself/himself better and recognize behavior

patterns that then allows her/him to implement behavior change strategies. Yet, if the

individual is not tolerant of her/his limitations, the insight into one's imperfections could
 32

create mental tension and anguish (McCallum & Piper, 1997). According to Farber

(1989), individuals who are psychologically minded are "wiser but sadder."

Etiology of Psychological Mindedness

The origin of psychological mindedness is debated. While some argue that it is a

trait or native disposition, others propose it is an ability that can be taught. Some of the

limited research focused on the origins of PM has found a correlation between early

childhood experiences and high PM (Henry, 1966; Henry 1977; Kohut, 1971; Miller,

1981). Most of the studies have focused on therapists as their samples, a group known

for being psychologically minded. A general trend among this research has found that

therapists report a dysfunctional relationship with their mother. The mothers are

described as either forceful and aggressive or pseudofeminine and clinging, or outright

psychopathological (Ford & Urban, 1963; Kohut, 1971).

Psychological mindedness has been associated with a number of personality traits.

In a study with a sample of 185 individuals, a significant correlation was found between

PM and Extraversion (r = .37; p< .01) and Openness to Experience (r = .40, p< .01) as

measured by the NEO-Five Factor Inventory (NEO-FFI; Costa & McCrae, 1992). Beitel

& Cecero (2003) found multiple correlations between personality traits measured by the

NEO-FFI and level of PM as measured by the PM Scale among 185 undergraduate

students. They reported a positive correlation between PM and Extraversion (r = .37; p<

.01) and Openness to Experience (r = .40; p< .01) and a negative correlation between PM

and Neuroticism (r = -.33;_p< .01).

Conte and her colleagues (1995) conducted two studies investigating the relation

between PM and personality traits. The sample in one study consisted of 46 medical
 33

students attending an outpatient clinic within their medical school with diagnoses of

affective, anxiety and adjustment disorders. The results found high PM scores, based on

the Psychological Mindedness Scale (Conte, 1990), were significantly correlated with a

number of traits measured by the Personality Profile Index. Those high in PM also were

high in assertiveness (r = .57; p< .001), sociability (r = .40; p< .01), low passivity (r = -

.59; p< .001), depression (r = -.34; p< .05) and conflict (r = -.30; p< .05). The students

with high PM scores also tended to have low submissive scores (r = -.27;/?< .10) and be

accepting of others (r =.24; p< .10). Those with high PM scores were more open to new

ideas, assertive, and sociable, while being low on depression, submission, passivity and

aggression. Participants with low PM scores endorsed items of high passivity,

depression, submission, and rejection of new ideas or behavior change.

The second study conducted by Conte et al. (1995) used a sample of 192 clinic

patients who were similarly diagnosed with affective, anxiety and adjustment disorders,

as well as schizophrenia and psychoactive substance abuse disorders. High PM Scale

scores were significantly correlated with ego functioning constructs as measured by the

Dynamic Personality Inventory (DPI) (Grygier, 1970) and the Self-Evaluation

Questionnaire (SEQ) (Conte et al. 1995). Ego strength was significantly correlated to

high PM scores (r = .5%;p< .001; mastery competence r = .51), p < .001; synthetic-

integrative functioning r = .49; p< .001), which implies adaptive functioning in all ego

areas.

A number of studies have evaluated demographic variables and found few

correlations with level of PM. Psychological mindedness has not been correlated to

gender and age in studies with samples ranging from non clinical volunteers, students,
 34

outpatients and chronic psychiatric patients (Beitel, Ferrer, & Cecero, 2004; McCullum &

Piper, 1997). Yet McCallum (as cited in McCallum & Piper, 1997) found a significant

positive correlation between PM and age (n = 190) in which younger psychiatric

outpatients had higher PM scores than the older outpatients in the same clinic (correlation

value not reported). In three of four studies conducted by McCallum & Piper (1997),

employment and marital status both were uncorrelated to PM. In one of the studies cited

above, higher levels of PM were predicted by being single and working from home.

Education has not been correlated to level of PM in previous studies with

homogeneous populations (McCullum & Piper, 1997; Conte et al. 1990; Conte & Ratto,

1997). Using the above mentioned studies, Conte et al. (1995) theorized that medical

students (with a mean of 16.98 years of education) would be more psychologically

minded when compared to regular clinic patients (with 12.10 years of education). The

medical students in fact did, on average, have higher PM scores than the outpatient

sample.

Psychological mindedness has not been consistently correlated to IQ. Dollinger's

(1997) measure, unlike other PM measures, is predicted by intelligence measure

comprehension scores, specifically interpretive versus literal comprehension.

Dollinger's studies find that intellectual competence plays a role in PM and that in order

to be able to "read between the lines" of another individual's behavior you must have a

restful and playful mental state. The relationship between education, IQ and PM remains

a theoretical question as limited PM research has been conducted using participants with

limited education or low IQ.

 35

Competence in the areas of humanities and social science is more predictive of

PM than competence in mathematics and natural science (Dollinger & McMorrow,

1991). This difference is reasonable, as individuals interested in sociology and biology

might both be interested in patterns. While sociologists may be more interested in

patterns of human behavior and interactions, biologists may be interested in non-human

interactions.

Psychological mindedness has been correlated to number of sessions attended and

patient's perception of greater benefit from psychotherapy, and has been predictive of

patient drop out in short term therapy but not in day treatment (Conte et al. 1990; Conte,

Ratto, & Karasu, 1996; McCallum & Piper, 1997; McCallum & Piper, & Ogrodniczuk,

2003). High PM levels predicted positive response and outcome in time limited

psychotherapy (Conte et al. 1990; Conte, Ratto, Karasu, 1996; McCallum & Piper, 1997;

Piper et al. 2001). Conte et al. (1990) found PM predicted improvement in global

functioning (r = .33; p< .05) and a decrease in psychosocial symptoms (r = -.37; p< .05)

as self reported by patients (n= 42) and their therapists post discharge. These results

were not replicated in a second study (Conte et al. 1993). Piper et al. (2001) found that

Canadian participants with higher PM scores (based on participant's ability to identify

dynamic components in two video recorded scenarios) reported less grief symptoms after

completing a 12 week outpatient complicated grief interpretive or supportive group

therapy.

Psychological Mindedness and Weil-Being

Ryff (1989) conducted interviews with a community sample of 171 middle aged

(M= 52.5 years; SD= 8.7) and older (M=73.5 years; SX>=6.1) men and women. The
 36

purpose of these interviews was to explore the lay person's beliefs about the relationship

between happiness, well-being and psychological mindedness. These middle aged and

older participants defined well-being and positive functioning as having a sense of

humor, being a caring and compassionate person, and having good relationships. They

reported that in order to be happy the person had to be self-confident, self-accepting, have

self knowledge and accept changes in life.

Emotional regulation has been associated to PM, as Trudeau and Reich (1995)

found the emotional well-being of 89 undergraduate students, defined as self acceptance,

a desire for autonomy and maintaining positive relationships with others, purpose in life,

personal growth through maximizing one's talents, and having mastery over one's

environment, was positively related to PM (r = .31; p< .01). Psychological mindedness

accounted for 10% of the variance in the student's mental well-being level; as their

psychological mindedness increased so did their mental well-being.

Psychological mindedness has not been shown to have a relationship with the

patient's level of functioning, psychiatric symptoms, and level of problems at time of

admission to a clinic (Conte et al. 1990; Conte, Ratto, & Karasu, 1996; McCallum &

Piper, 1997). The relationship between PM and DSM diagnosis is unclear. Two studies

found no relationship between PM and psychiatric diagnosis (McCallum, 1989; Piper et

al. 1994). Piper et al. (1994) found that patients who had been diagnosed with MDD at

some point in their life, but did not carry the diagnosis at the time of the study, had a

higher probability of having high PM scores than patients who had never been diagnosed

with MDD. Another study found that psychological mindedness is predictive of

individuals who carried a lifelong mood disorder diagnosis (McCallum & Piper, 1997).
 37

These results ought to be considered with care as McCallum & Piper (1997) caution that

the results from the two above mentioned studies were found after a number of statistical

tests and might be due to chance.

It is proposed that individuals low in psychological mindedness tend to manifest

their psychological problems in somatization disorders (Fenchel, 2005; Moodley, 2006).

Kleinman (1977) defined somatization as the "expression of personal and social distress

in an idiom of bodily complaints with medical help-seeking." Somatization disorders are

often co-morbid with disorders such as depression, panic disorder, personality disorders

and post-traumatic stress disorder. Kleinmen (1987) reported that, "somatic symptoms in

depression and anxiety disorders play a more central role in the experience and

expression of disorders in non-Western societies and among ethnic groups in the West."

Researchers and psychotherapists often describe Latinos as individuals who somatisize

their psychological distress, are concrete and lack insight (Caro, personal communication;

DeJesus, personal communication; Katon, Ries, & Kleinman, 1984; Kleinman,

Eisenberg, & Good, 1978). Researchers have begun to examine somatization as being an

expression of the person's cultural norms, self-esteem regulation, or as a coping strategy,

and not as proof that these individuals are uninsightful about their psychological distress

(Baumann et al. 1989; Fenchel, 2005; Katon, Ries, & Kleinman, 1984; Karasz &

Anderson, 2003; Karasz, Sacajiu, & Garcia, 2003; Moodley, 2006; Mumford, 1993).

Little research has been conducted to identify the extent of psychological

mindedness (PM) among Latino populations, and even less research on Latinos seeking

psychological services. Tiago De Melo, (1998) conducted one known study focused on

examining the role psychological mindedness plays in treatment seeking behaviors for
119 Hispanic and non-Hispanic White Americans. The participants completed the

Psychological-Mindedness Scale (Conte et al. 1990), the Toronto Alexithymia Scale

(Bagby, Taylor, & Parker, 1994), and the Short Acculturation Scale for Hispanics (Marin

et al. 1987), as well as a Willingness to Seek Help Scale (Tiago De Melo, 1998) devised

for this study. No significant differences between Hispanic and non-Hispanic White

Americans' willingness to seek therapeutic help were found. More than ethnicity, high

social class and high acculturation may play an important role in predicting willingness to

seek therapy. Higher levels of psychological-mindedness and lower alexithymia scores

predicted whether Hispanics were willing to seek help. No other variables were

significant predictors.

Most PM studies have a small representative sample of Latinos (i.e., 20%), which

makes it difficult to generalize overall research results to Latinos specifically. The

relationship between PM and SWB has received little empirical attention. No study to

date has focused on PM in a purely Latino population, and none has evaluated whether

PM is predictive of subjective well-being. Theory and research supports that PM is a

stable personality characteristic. Based on the Dynamic Equilibrium Model, PM will be

considered a stable trait when evaluating its association with SWB.

Acculturation

When an individual relocates to a new environment and has direct and continuous

contact with individuals from different cultures the individual undergoes an adaptation

process commonly known as acculturation (Ryder et al. 2000). The process of

acculturation to a new country by an immigrant can be stressful due to a variety of

reasons that include severing of familial ties, language deficits, limited social and
financial resources in the host country, feelings of not belonging in the new culture,

confusion regarding new culture's customs and pressure to conform to new norms and

values that might oppose traditional beliefs (Hovey, 2000; Rogler, Cortes, and Malgady,

1991). Although research on acculturation has been conducted on diverse populations,

the focus of this literature review will focus on Latino populations (Dinh, 2000; Liebkind

& Jasinskaja, 2000; Schnittker, 2000; Ward & Rana-Deuba, 1999; Young, 1996).

Theoretical Models of Acculturation

Over the last century the concept and definition of acculturation has gone through

many changes. It has been defined in terms of a group process and an individual

experience. Redfield, Linton and Herskovits (1936) defined acculturation at a group level

as "those phenomena which result when groups of individuals having different cultures

come into continuous first-hand contact, with subsequent changes in the original cultural

patterns of either or both groups (p. 149)." Graves (1967) defines acculturation at an

individual level as encompassing changes in attitudes, behaviors, beliefs, values and

preferences. Acculturation has been theorized and conceptualized by multiple models

(Glazer, 1971; Gordon, 1964; Kurilla, 1998; LaFromboise, Hardin, & Gerton, 1993;

Ryder et al. 2000; Zea et al. 2003). Refer to Figure 1 for a visual representation of the

acculturation models that will be reviewed within this paper.

Acculturation has typically been conceptualized on a continuum, where

identification with one's native culture, here referred to as minority; and the host or

majority culture, occurs along a linear process (Kim & Abreu, 2001). This process is

rated as low acculturation on one end of the continuum and high on the other end of the

continuum. Gordon (1964) first proposed the model of assimilation as one that required
 40

loss of the minority culture in order to penetrate into the majority culture and achieve

social acceptance. The assumption is that a hierarchical relationship exists between both

cultures, with the majority culture being more desirable. Theorists who ascribe to this

model of assimilation see the process as a change in cultural identity that occurs along a

single continuum, with individuals exclusively identifying with their original minority

culture or exclusively embracing the majority culture. The assumption is that over time,

the minority individual adapts more to the majority culture due to exposure until they are

indistinguishable from individuals born into the majority culture. The assimilation model

argues that the individual will eventually lose all identification with the minority group,

become full members of the majority group, and have access to major social structures

(Glazer, 1971). This model fails to explain why some individuals who assimilate, such as

African Americans and Mexican Americans, fail to gain equal access to resources

(Harris-Reid, 1999).

The acculturation model is a bipolar model of acculturation that assumes that the

minority and majority culture are mutually exclusive and that the process of acculturation

occurs somewhere in between both cultures (Kurilla, 1998; LaFromboise, Hardin, &

Gerton, 1993). This bipolar model labels individuals who maintain and function largely

within their native or minority culture as unassimilated and nonintegrated, those that

"reject" their native culture and function fully within the majority culture as assimilated

and integrated, while those that function proficiently in both cultures as bicultural.

Ramirez (1984) defined a bicultural person as an individual with "extensive socialization

and life experiences in two or more cultures and participates actively is these cultures" (p.

82). Biculturalism is seen as an important aspect of the linear model of acculturation, as

 41

the individual could retain aspects of their minority culture while accommodating to the

majority culture (Kim & Abreu, 2001).

This bipolar model assumes that the immigrant struggles within the majority and

minority culture at the same time. In order for the new immigrant to best function and

survive economically in the majority culture, s/he must give up or lose all or part of

her/his native or minority culture (Smither, 1982). The individual is perceived as

relinquishing her/his minority customs and beliefs while adopting the values of the

majority culture. Unlike the assimilation model, the bipolar model implies that although

the individual can become competent in the majority culture, s/he will always be

identified as a member of the minority group.

Modifications to this bipolar model have been made over the years and

incorporate multiple cultural factors. Triandis (1980) proposed that the process of

acculturation may occur at varying rates, with adaptation of different cultural values

taking place at different times. The individuals could take on elements of the majority

culture in an exaggerated manner or retreat on previously accepted majority customs in

an effort to reaffirm their minority culture.

The multicultural model proposes that multiple cultures within close proximity of

each other can maintain their own characteristics (Berry, 1986). Individuals maintain

their own cultural identity while interacting or working for common goals with

individuals of other cultures. The individual has a positive view of their cultural identity,

while also viewing the other cultures in a positive light. However, there is little evidence

that distinct cultural separation among groups can be maintained over a long period of

time (Fishman, 1989).

 Gleason describes the fusion model as similar to the notion of the melting pot (as

cited in LaFromboise, Hardin, & Gerton, 1993). The fusion model suggests that cultures

that interface at an economic, political and/or geographic area fuse together into one new

culture. The cultures are equal partners that bring both their strengths and weaknesses

and melt into a new common culture. The minority and majority cultures both make

contributions to this new culture. Some have proposed that those in the minority group

must first go through an assimilation process into the majority group before fusion

occurs. Examples of a successful fusion of cultures are rare, although an example of

fusion could include aspects of the different cultures being incorporated such as food and

music.

The commonly used bipolar model does not explain how many individuals live

and function effectively within both cultures. It fails to truly capture biculturalism, or a

high adherence to both minority and majority cultures (Kim & Abreu, 2001). The use of

this model fails to capture alternatives to assimilation, such as integration or cultural

identities of both cultures (Ryder, Alden, & Paulhus, 2000). Use of bipolar measures

could provide misleading information that is not sensitive to the complexity of

individual's cultural identities and self-schemas. An individual that functions effectively

in both cultures and has distinct identities within both cultures, would look the same on a

bipolar measure as a person who has embraced both cultures equally and is bicultural.

A new conceptualization of acculturation, which will be used in this study, looks

at the process as bilinear and bi-directional (Kim & Abreu, 2001; Zea et al. 2003). This

evolution of acculturation theory moves from a linear process where the immigrant

assimilates from the minority culture to the majority culture, to a bilinear process in
 43

which the immigrant changes at both the minority and the majority level and can be

identified along two cultural dimensions (Birman, 1998; Cortes, Rogler, & Malgady,

1994; Kim & Abreu, 2001; Zea et al. 2003). This model allows for individuals to fully

identify with one or more cultures at once and to varying degrees, from high to low

identification and competence (Kurilla, 1998; LaFromboise, Hardin, & Gerton, 1993;

Ryder, Alden, & Paulhus, 2000). Culture is not treated hierarchically within this bilinear

model and the individual is not adapting from a minority culture to a majority culture.

The individual is not considered "bicultural," but instead becomes acculturated at two

levels, within the culture of origin and within the host culture (Zea et al. 2003). For

example, the individual could fully function in both cultures or function well in one and

moderately well in the other. This orthogonal, bi-directional or bilinear model is broader

and potentially more inclusive of subjective individual experience. In other words, these

individuals could speak both languages, are aware of cultural norms and customs, and

function effectively within both their native minority culture and the majority culture.

The individual can alter her or his behavior to fit the social context s/he is in. It also

acknowledges that culture is not the only dimension individuals identify with, and could

include other factors such as occupation or religion. This bi-directional model proposes

that there is no hierarchical relationship between the two cultures and therefore each

culture can be assigned equal value by the individual. It is also possible for the

individual to have a positive relationship with both cultures without having to choose

between them.

In order for the individual to function within the minority and majority culture,

s/he must be culturally competent within both (Rogler, Cortes, & Malgady, 1991).
 44

LaFromboise, Hardin, & Gerton (1993) proposed a behavioral model of cultural

competence on a multifactor continuum that encompassed social skills and personality

development. An individual who is culturally competent would:

(a) possess a strong personal identity, (b) have knowledge of and facility
with the beliefs and values of the culture, (c) display sensitivity to the
affective processes of the culture, (d) communicate clearly in the language
of the given cultural group, (e) perform socially sanctioned behavior, (f)
maintain active social relations within the cultural group, and (g) negotiate
the institutional structures of that culture (pp. 4).

Every individual will not be proficient at all levels within both cultures. Yet, the more

levels of competence that an individual achieves, the easier the individual can function

within and negotiate between both cultures.

Acculturation has been assessed through validated measures ascribing to the

various models (Cortes, Rogler, & Malgady, 1994; Cuellar, Arnold, & Maldonado, 1995;

Olmeda & Padilla, 1978), as well as indirect proxy variables such as language preference

(Hovey, 2000; Krause, Bennett, & Van Tran, 1989), national origin (Krause, Bennett, &

Van Tran, 1989; Krause & Goldenhar, 1992), attitude towards native and host culture

(Kaplan & Marks, 1990), years of residence in host country (Harris-Reid, 1999), and self

ascribed labels (Kim & Abreu, 2001). This disparate method of assessing acculturation

makes it difficult to generalize research results (Nagy & Woods, 1992). The inconsistent

use of multiple measures and theories of acculturation makes the validity of the results

questionable, and might explain why inconsistencies regarding the relationship of

acculturation and SWB abound (Rogler, Cortes, & Malgady, 1991). With this

measurement limitation acknowledged, the following is a review of the most relevant

studies of acculturation and subjective well-being.

 45

Figure 1. Visual Representation of Acculturation Models

Assimilation (linear, one directional)

< •
Minority -> Majority
Loss of Original Culture

Acculturation (linear, bipolar)

Unassimilated Bicultural Assimilated

<«H 1 r>

Minority -4- •> Majority

Multicultural
Culture A
•
Culture B
•
Native Culture
•

Low Acculturation Level High

Fusion
Minority A

Minority B • Majority

Minority C

Bidirectional & Bilinear

High Low

High Low
 46

Psychological Effects of Acculturation on Weil-Being

Theorists have argued that individuals who belong to two cultures, whether this is

due to being born to inter-racial parents or being born in one culture and then being raised

in another culture, could be considered marginal people (Handlin, 1951; Park, 1928;

Stonequist, 1935; LaFromboise, Hardin, & Gerton, 1993). This marginal person

experiences psychological conflict in that s/he perceives herself or himself as a divided

self, with divided loyalty, and feel like an alien within two cultures. The assumption here

is that being of two cultures is undesirable as it leads to confusion regarding one's

cultural identity (Pearlin, 1983). Rogler, Cortes, & Malgady (1991) cite that individuals

who do not integrate into the host culture might experience distress because they have

been uprooted from support networks. The member of a minority group might face

"hostility, prejudice, lack of support and the development of a cognitive coping style that

can be counterproductive" (Mortisugu & Sue, 1983, pp. 162).

Many sociologists have proposed that although this experience can be

psychologically uncomfortable, it is beneficial for society, as progress among humanity is

dependent upon cultural exchange. Not all view the adjustment into the host culture as a

negative experience. Members of minority groups often experience economic and social

discrimination, yet suggesting that they always experience negative psychological

distress is inappropriate (Rogler, Cortes, & Malgady, 1991). Bodner (1985) suggested

that immigrants are strengthened by relying on cultural institutions, such as family,

church membership, and ethnic aid groups. Perception of what has been gained (i.e.,

freedom and economic security) or lost (i.e., close family ties) as a result of immigration

is essential to determining subjective distress (Rogler, Malgady, & Rodriguez, 1989). It

 47

is the nature of the stress and how it is perceived that impacts SWB. Rogler, Cortes, &

Malgady (1991) propose that the best condition for health is for an immigrant to retain

traditional support groups and participate in positive traditional cultural elements, while

also learning the host society's norms and customs.

Few studies have evaluated the relationship between acculturation and SWB.

There is no general consensus among researchers concerning the relationship of

acculturation level and psychological distress (Cuellar and Roberts, 1997; Rogler, Cortes,

& Malgady, 1991; Vega, Warheit, & Meinhardt, 1985). Several studies support the

positive relationship between perceived control over experiences with the majority

culture and lower reports of negative effects due to acculturation stressors (see review by

LaFromboise, Hardin, & Gerton, 1993). Research has supported the notion that those

that can alternate, specifically individuals who are bilingual, have higher cognitive

functioning and mental health status than people who are mono-cultural, assimilated, or

simply acculturated (Rogler, Cortes, & Malgady, 1991).

Specifically, Martinez (1987) conducted a study comparing the effects of

acculturation among Puerto Rican college students living in the United States (as cited in

LaFromboise, Hardin, & Gerton, 1993). He found that bicultural involvement was the

strongest predictor of self-esteem and well-being. Other studies have confirmed this

correlation between bicultural orientation and positive psychological well-being (Kurilla,

1998; Murguia, 2002). Kurilla (1998) studied 107 professional Hispanic women using

the orthogonal acculturation model. She found that women who identified strongly with

both White majority and Hispanic cultures also reported satisfactory levels of

psychological well-being.
 48

Lang, Munoz, Bernal, and Sorensen (1982) conducted a telephone survey of 270

Hispanics and sought to identify if a relationship existed between their psychological

well-being and their level of acculturation. They found that individuals who were

bicultural also reported lower levels of depression and negative affect. The better

adjusted individuals, when compared with those that reported higher levels of distress,

were more oriented toward the Latino culture than toward the Anglo-American culture.

The more adjusted participants had better paying jobs, were more educated, had resided

in the United States for a longer period of time, and were more acculturated. The

relationship between level of education and financial problems to SWB has been

replicated (Krause, Bennett, & Van Tran, 1989; Olmedo & Padilla, 1978).

Lopez (1996) supported this finding in part, as she did not find that biculturalism

was associated with SWB, but that being oriented toward the culture of origin was related

to positive SWB. In her study, Latin American students were assessed for high or low

Latin orientation and were then exposed to a condition where their self-concept was

threatened through a depiction of negative personality traits. The participants then wrote

a self-affirmation essay for 10 minutes, either about their culture, a general theme, or a

control topic. The three groups then completed two measures of negative affect and self-

esteem. The higher Latin orientation buffered distress, with high Latin orientation

participants who wrote the cultural self-affirmation essay reporting the least distress.

Interestingly, for the lower Latin orientation participants, completing the cultural self-

affirmation essay seemed to threaten their self-concept most, as they reported lower self-

esteem after completing the self-affirmation essay than the control group.
 49

Some studies have examined the predictive power of acculturation on variables

such as depressive symptoms and stress in Latino samples (Krause, Bennett, & Van Tran,

1989; Meluk, 2002). One study of immigrants, 65 years or older, found lower levels of

depression among those with higher acculturation levels (Krause, Bennett, & Van Tran,

1989). Unfortunately, acculturation level was operationalized by "language used" only.

Some studies have reported equal rates of mood disorders between ethnic

minorities and White Americans (Miranda, Lawson, & Escobar, 2002). Others report

that demographic variables, such as gender, education and socioeconomic status, are

better predictors of psychological distress than acculturation (Cuellar & Roberts, 1997;

Miranda, Lawson, & Escobar, 2002). Many studies have linked migration status, rather

than acculturation, to a higher incidence of psychological disorders, such as Major

Depressive Disorder (Burnam et al. 1987; Rogler, Cortes, & Malgady, 1991), anxiety

disorders (Karno et al. 1989), and alcohol abuse (Rogler, Cortes & Malgady, 1991).

Vega, Warheit, Buhl-Auth, and Meinhardt (1984) conducted an epidemiological

study of Mexican-Americans living in Santa Clara, California. They found that Spanish

speaking Mexican-Americans reported higher levels of depressive symptoms when

compared to English speaking Mexican-Americans. Similar to other studies, they also

found that Mexican-American women reported higher levels of depression than the men

(Salgado de Snyder, 1987; Roberts & Roberts, 1982). Specifically, they report that

women, individuals with marital conflicts, low educational levels, and individuals under

30 had significantly higher levels of depressive symptoms. Gender differences have not

been consistently found in other studies assessing acculturation and subjective well-being

(Murguia, 2002; Perez, 1998).

 50

Hovey (2000) found a significant correlation between the level of acculturation,

as measured by language use, acculturative stress, and level of depression and suicidal

ideation among immigrants of Mexican descent. Additional factors significantly

correlated to depressive symptoms and acculturative stress include lack of English

proficiency, lack of control over the decision to migrate, recent migration (the past 5

years), low socio-economic status (SES), reduced health status and lack of confidant

support (Salgado de Snyder, 1987; Vega et al. 1984). Hovey concluded that high

acculturation levels may act as a protective factor against psychological distress.

Other studies have found an age effect, where individuals with higher

acculturation levels reported more distress if they were young adults, while older adults

reported less distress (Kaplan & Marks, 1990; Rogler, Cortes, & Malgady, 1991).

Krause, Bennett, & Van Tran (1989) examined whether factors such as financial

difficulty and age were associated with acculturation and in turn affected the subjective

well-being of 859 individuals of Mexican descent. They used indirect measures of

acculturation such as national origin and language preference to assess acculturation

level. This study attempted to go beyond establishing a correlation between acculturation

and well-being and sought to find the model of how acculturation might affect well-

being. Surprisingly, they found that individuals who were less acculturated reported

higher levels of well-being. Individuals who were born in Mexico reported experiencing

less financial stress, possibly because they experienced higher levels of poverty in

Mexico (Rogler, Cortes, & Malgady, 1991). They did not find age differences, but did

find a positive relationship between reports of financial stress, preference for the Spanish

language, and diminished feelings of control and self-esteem. In turn, those with lower
 51

self-esteem and sense of control reported higher levels of somatic and depressive

symptoms. Rogler, Cortes, & Malgady (1991) study is problematic due to the simplistic

method of assessing level of acculturation and therefore the results should be evaluated

with caution.

A national survey of 3,000 minority participants, which included Black, Latino

and Asian immigrants found that acculturation predicted psychological distress and life

satisfaction for the overall sample (Harris-Reid, 1999). Among the entire sample

acculturation positively predicted psychological distress, but negatively predicted life

satisfaction reports. Unfortunately, like Krause, Bennett, & Van Tran (1989), the

acculturation level was assessed through indirect factors such as nativity and generational

status instead of through validated acculturation measures.

While many studies have found a relationship between acculturation and well-

being, contradictory results exist that negate this relationship (Funk, 1993; Quinones,

1996; Perez, 1998; Rogler, Cortes, & Malgady, 1991; Urizar, 2002). Perez (1998) did

not find a relationship between acculturation, migration stressors and psychological

distress among 127 Dominican immigrants. She found that personal characteristics, such

as hardiness, directly influenced psychological distress, assessed as depressive, anxiety

and somatization symptoms. Golding and Burnam (1990) did not establish a positive

correlation between acculturation level and depression as they found that U.S. born

Mexican-Americans reported higher levels of depressive symptoms when compared to

immigrant Mexicans. In another study, Cuellar and Roberts (1997) investigated 1,271

first and second year Latino college students and did not find a relationship between
 52

acculturation and risk for depression. Depression scores were correlated to gender and

socio-economic status, but not to acculturation level or ethnic identity.

In summary, the acculturation research does not provide a clear portrait

concerning the relationship of acculturation level and psychological distress. Many

studies support the positive relationship between acculturation levels and SWB, reporting

that individuals who are highly acculturated or bicultural also report lower levels of

distress. Yet several studies do not support this relationship, reporting that individuals

high in acculturation experience more psychological distress and immigrants low in

acculturation experience higher levels of SWB. Confounding the issue even more, a

couple of studies have found no relationship between acculturation and SWB.

Using the Dynamic Equilibrium Model as a guide, acculturation level would be

treated as an exogenous event driven by endogenous personality traits. It is unclear

whether the individual's personality traits return SWB to a normal equilibrium level

independent of the acculturation process or whether acculturation would predict SWB

beyond the individual's personality traits. The present study sought to add to the existing

literature concerning the predictive relationship of acculturation level and subjective

well-being.

Purpose and Rationale

The objective of this study was to examine whether certain personality traits

(FFM), Psychological Mindedness and Acculturation level predict the Subjective Weil-

Being of Latinos seeking psychotherapy. The Dynamic Equilibrium Model argues that

SWB is influenced by the FFM and some research exists on the predictive power of FFM

on SWB, but most research available has been conducted with non-Hispanic samples.
 53

This study evaluated the generalizability of these findings to a clinical Latino sample.

Little research has looked at psychological mindedness and level of acculturation.

Specifically, how these two variables alone and combined might predict subjective well-

being in a Latino sample. Some conflicting information exists on the relationship

between acculturation level and subjective well-being. This study sought to clarify this

knowledge base.

Conceptual Hypotheses

It was hypothesized that:

1. Based on the Dynamic Equilibrium Model of Subjective Well-Being,

Subjective Well-Being level would be predicted by the stable

personality traits of Neuroticism, Extraversion and Openness to

Experience, such that the lower the Neuroticism level and the higher

the Extraversion and Openness to Experience, the higher the level of

Subjective Well-Being.

2. Stable Psychological Mindedness would be associated with Subjective

Well-Being, as Subjective Well-Being would be predicted by high

Psychological Mindedness levels beyond the effect of the stable Five

Factor Model traits.

3. Subjective Well-Being would be significantly predicted by the

exogenous experience of Acculturation beyond the effect of the stable

Five Factor Model traits and Psychological Mindedness.

 54

4. The overall level of Acculturation for both U.S. American and culture-

of-origin dimensions would predict higher levels of Subjective Well-

Being.
 CHAPTER II: METHOD

Participants

The Latino study participants were recruited from two community mental health

outpatient clinics specializing in providing bilingual psychotherapy within a New York

City public hospital. Of the 110 eligible individuals approached, 100 consented to

participate, 36% («= 36) were recruited from the long-term treatment clinic and 64% (n=

64) from the time limited treatment clinic. All but two individuals required the

questionnaires be read to them aloud due to illiteracy. Many participants reported they

could read, but preferred that the lengthy measures be read to them. A total of 6

individuals completed the English version of the measures, as compared to 94 individuals

who completed the Spanish version. No major differences were found between the

Walk-In Clinic (time-limited; 1 to 6 sessions) and Bilingual Treatment Program (long-

term) clinic participants, when t-test, ANOVA, and chi-square analyses were used to

compare demographic, and independent and dependent variables.

The original subject pool was unevenly distributed by gender, with an almost 4 to

1 ratio favoring female subjects. The final sample consisted of 100 participants, 77%

(n=77) female and 23% («=23) male, ranging in age from 22 to 82 years old, with a

mean age of 46.7 (SD=13.5). Refer to Table 3 for additional demographic information.

All but 2% (n=2 ) of the Latino participants were born outside of the United

States. The Latino sample's ethnic breakdown is presented in Table 4. One participant

immigrated from Spain, yet her responses were within range of the other Latino

participants. The mean number of years living within the United States was 18.6, with a

standard deviation of 14.3. With regards to education, 68% («= 68) of participants

55
 56

reported less than 12 years of education, 17% (n= 17) had a high school diploma or

equivalent, and 15% (n= 15) reported some education beyond high school. The majority

(48%, n= 48) of participants reported being married, although 25% {n= 25) were single

and 27% (n= 27) were divorced, separated or widowed.

Table 3

Summary of Demographic Information

Variable Mean SD Min Max

Age 4677 13^5 22* 82*

Years in U.S. 18.8 14.3 .25* 62*

Education 8.6 4.1 0* 23*

Previous treatment 5.3 12 0 84

by Months

Notes: * = years, N= 100

More than half the sample reported being unemployed (67%, n= 67), while 16%

(n= 16) reported working part-time and 17% («= 17) reported working full-time. In turn,

a majority of the sample reported being in a low income bracket, with 57% (n= 57)

earning between $0 to $10,000 per year, 34% (n= 34) earning between $10,000 to

$20,000 per year, 8% (#»= 8) earning 20,000 to 30,000 per year, and only 1% (n= 1)

earning 40,000 to 50,000 per year. Based on the 2005 U.S. Bureau of Census press

release on poverty rates and as defined by the Office of Management and Budget, "the

average poverty threshold for a family of four in 2006 was $20,614; for a family of three,

$16,079; for a family of two, $13,167; and for unrelated individuals, $10,294."

According to the U.S. Bureau of Census 2006 press release, the national poverty rate is
 57

11.9%, while 15.2% of the foreign born population, live below the poverty line.

However, 20.6% of Latinos were in poverty in 2006. A total of 91% (n= 91) of this

sample earned less than $20,000 per year, and fell within the poverty threshold. This

study's sample is over-representative of the large percentage of Latino and foreign born

population living in poverty.

Table 4

Demographic Information: Country of Origin

Country of Origin N % of sample

Ecuador 25
Dominican Republic 21 21
Puerto Rico 16 16
Mexico 15 15

Colombia 5 5

Peru 5 5
Honduras 4 4
Argentina 2 2
Guatemala 2 2
U.S. Puerto Rican 2 2
Venezuela 1 1
Chile 1 1
Spain 1 1

Notes: N = 100

The participants were new patients to the clinics, although some reported

participating in psychotherapy in the past. Fifty-eight percent («= 58) of the participants

had never attended treatment, while 42% («= 42) had attended some treatment in the
 58

past. The participants' mean length of treatment history prior to the present intake

session was 5.3 months, with a standard deviation of 12 months.

Procedures

The study's Latino participants were recruited at time of intake from either a

long-term or time specific (one to six sessions) outpatient community mental health clinic

specialized in providing bilingual psychotherapy within a New York City hospital.

Exclusion criteria included individuals with a history of psychotic or dementia symptoms.

After informed consent was obtained, the participants were given a packet that included a

demographic questionnaire, the Psychological Mindedness Scale (PM Scale), the

Abbreviated Multidimensional Acculturation Scale (AMAS-ZABB), the Psychological

General Well-Being Schedule (PGWBS), the Schwartz Outcome Scale- 10-E (SOS-10-E),

and the Big Five Inventory (BFI). Except for the demographic questionnaire, all

measures were randomly ordered. The participants were given the options of completing

English or Spanish forms and due to literacy issues, the questions were read aloud to 98

(98%) of the participants by this researcher. If the participant had a question regarding

word meaning, this researcher provided the word's definition and like words. This

occurred at least once with approximately 30% of the participants. Once all measures

were completed, the participant was given a written debriefing form and given an

opportunity to ask questions regarding the study.

Instrument Translation Procedure

Measures that were only available in English were translated into Spanish and

back-translated to verify the same construct was captured in the Spanish version (Arnold

& Matus, 2000; Berry, 1986; Brislin, 1970,1976; Rivera Mindt et. al. 2003). The
 59

methodology used within this study was the Back Translation Method and the Team or

Panel Method, which are described in greater detail by Arnold and Matus (2000). The

translation from English into Spanish was conducted by a Masters level clinical

psychology graduate student and a California State Certified Spanish translator. The

back translations from the Spanish version to English were conducted by a group of five

individuals who worked in the mental health field, with ethnic identification of Mexican

national, Mexican American, Spanish national, Dominican American, and Spanish

speaking non-Hispanic White. All but the non-Hispanic White member of the team were

native Spanish speakers.

The back-translated version was then compared by the team of fluent bilingual

(English/Spanish) speakers independently with the original English scale to assess any

discrepancies. Any discrepancies between the original and back translated versions were

discussed by the panel as a group and a consensus as to accurate meaning or wording was

reached. When a discrepancy arouse on two occasions, the panel first agreed upon the

meaning or intent of the English measure and then compared the meaning of the

individual Spanish translations. The panel then discussed and agreed upon which of the

individual Spanish translations was closest to the meaning of the original English

question. The agreed upon wording was used as the final version for the translated

measure.

Instruments

Five Factor Model of Personality

The Big Five Inventory (BFI)-Spanish version (Benet-Martinez & John, 1998) is

a self-report measure of the five traits in the Five Factor Model that includes 44
characteristics, scored on a 5-point Likert scale ranging from "agree strongly" to

"disagree strongly." The BFI has substantial convergent validity with Costa and

McCrae's (1992) definitions of the Five-Factor Model. The factors themselves refer to

real, consensually validated aspects of human behavior that can be treated quantitatively.

The BFI English version's reliability and validity has been established by using

multiple samples, including three hundred and thirty six 17 to 59 year old African

American college students (Worrell & Cross, 2004). Canadian and American samples

were compared and the alpha reliabilities ranged from .75 to .90, and at a three month re-

test reliabilities ranged from .80 to .90. The inter-correlations between the five scales

were low, most below .20 (John & Donahue, 1998). The BFI has convergent validity

with Costa and McCrae's The NEO Personality Inventory-Revised (NEO-PI-R) and

Goldberg's personality scale (mean r = .75 and .80, respectively).

Benet-Martinez & John (1998) translated the BFI into the Spanish language and

validated the translated measure in three separate studies. They compared the Spanish

and English BFI versions with college students from Spain and the United States. The

internal consistencies in the English language scales were high with average alpha being

.83, while the average alpha coefficients for the Spanish translation was .78. The means

and standard deviations for both samples were similar. The second study used a sample

of college educated bilingual Latinos. Cross language convergence between the Spanish

and English BFI ranging from .65 to .84. The authors report that discriminant validity

evidence exists with indigenous Big Five markers (Benet-Martinez & Waller, 1997), as

only 3 of the 20 off-diagonal correlations exceeded .30. Convergent validity was

established, as alpha coefficients for the NEO-FFI scales were similar to the BFI scales,
 61

with a mean of .79 and .82 respectively. The third study replicated the findings from the

second study using a working class bilingual Latino sample. The reliability between both

languages ranged from alpha means of .73 to .80 for the English version and .69 to .77

for the Spanish version.

Psychological Mindedness

The Psychological Mindedness Scale (PM)-Spanish translation (Conte et al. 1990)

is a self-report scale that includes 45 items, scored on a 4-point Likert scale ranging from

"strongly agree" to "strongly disagree" (see Appendix A). This scale was based on

Lotterman's (1979) unpublished 65 item scale. The scale was designed to measure

psychological mindedness, or the "degree of access to one's feelings, willingness to

understand oneself and others, belief in discussing one's problems, interest in meaning

and motivation of behavior and capacity for change (Conte, Ratto, & Karasu, 1996)."

Twenty four of the items load positively with PM, while 21 load negatively and must be

reverse coded.

This measure was translated into Spanish for use in this study. The translation

method is described in more detail within the Instrument Translation Procedures Section.

The following includes examples of questions in this measure and their translation into

Spanish. English version, "I would be willing to talk about my personal problems if I

knew that it could help me or a member of my family." Spanish translation, "Estaria

dispuesto/a a hablar de mis problemas personales si pensara que podria ayudarme a mi o

a un miembro de mi familia." English version, "I think that most people that have a

mental illness have a brain problem." Spanish version, "Creo que la mayoria de la gente

que tiene una enfermedad mental tienen algo mal en el cerebro."

 62

Upon factor analysis, no unitary or higher order factor was found but three factors

were discovered: I) Avoidance of Insight, II) Openness to New Ideas, and III) Access to

One's Feelings (Conte et al. 1990). Another factor analysis using the data of 250

psychiatric outpatients resulted in five factors, with 29 out of the 45 items accounting for

the five factors (Conte et al. 1993). Conte et al. (1996) confirmed the same five factors

previously identified by Conte et al. (1993) and proposed that these factors added

additional facets to the concept of Psychological Mindedness previously defined. Conte

et al. (1990) reported good internal consistency of the scale (Cronbach's a=.86 and .87)

and good temporal stability (a= .92) in two psychiatric outpatient samples (n= 69 and «=

250). In a predominately high school educated non-Hispanic White and African

American clinical sample, the mean PM score reported was 130.69 (SD= 14.1). Test-

retest reliability over a two week period for a sample of 22 normal adults was .92,

indicating good stability. PM scores were significantly correlated with number of

therapy sessions attended. PM Scale correlated negatively with the Toronto Alexithymia

Scale (TAS-20) which measures alexithymia (the converse of PM) and supports construct

validity (Bagby, Taylor, & Parker, 1994). For the purpose of this study, the PM Scale

has been translated into Spanish, and therefore has not yet been validated with a Spanish-

speaking Latino sample.

Acculturation

The Abbreviated Multidimensional Acculturation Scale (AMAS-ZABB; Zea et al.

2003) is a bilinear (separate measurements of adaptation within the culture of origin and

within the host culture), and multidimensional scale of Acculturation that measures

cultural competence, cultural identity and language competence. This self-report scale
 63

contains 42 items scored on a 4-point Likert scale ranging from "strongly agree" to

"strongly disagree." This scale assesses the dimension of 6 factors associated with

acculturation in the United States and culture-of-origin, that include identity, language

competence and cultural competence. The average of these factors captures the level of

acculturation on the U.S.-American dimension (three factors) and the culture-of-origin

dimension (three factors). Biculturalism can be assessed by multiplying the U.S.-

American dimension average and the culture-of-origin dimension average. Based on

preliminary results, high scores (12-16) indicate biculturalism, while low scores (1-2)

indicate marginalism. The meaning of scores in the middle requires additional research

to better understand their significance.

The English and Spanish version of this scale was validated on community

(n=90) and college student (n=\56) Latino samples (Zea et al. 2003). The college

student sample consisted of 156 Latinos born in South and Central America, Mexico,

Spain, the Caribbean, and United States. The community sample included 90 immigrants

from Central America. Among the college sample, evidence of good internal validity for

all 3 subscales was found (Cronbach's a = .90 to .97). Construct validity was

demonstrated through factorial analysis with a varimax rotation using the scores of all

246 participants. The rotation yielded six factors with eigenvalues greater than one, and

that accounted for 77.6% of the variance in the scale. Concurrent validity was also

assessed by comparing the score of participants that were born in a Latin American

country with those that were born in the United States, and statistically significant

differences were consistent. This measure has subsequently been used with a HIV
positive gay Latino male sample with similar results (Bianchi, Reisen, & Zea, 2006).

This measure is generalizable to both U.S. born and non-U.S. born Latinos.

Adequate convergent and discriminant validity was shown by administering the

Bicultural Inventory Questionnaire-Form B (BIQ-B) Hispanicism and Americanism

scales (Birman, 1991; 1998) on a college sample. The U.S.-American dimension was

significantly related to BIQ-B Americanism, with r = .48, while the culture-of-origin

dimension was not related by r = -.18. The culture-of-origin dimension was significantly

related to BIQ-B Hispanicism, with r = .41, while the U.S.-American dimension was

negatively related by r = -.36.

The community sample consisted of "immigrants, refugees, and sojourners or

migrant workers" (Zea et al. 2003, pp.115). Among the community sample, evidence of

good internal validity for all 3 subscales was found (Cronbach's a = .83 to .97).

Convergent and discriminant validity was assessed by comparing the scales against

Phinney's (1992) Multigroup Ethnic Identity Measure (MEIM). Scores from the MEIM

were related to all the factors from the AMAS-ZABB. For example high levels of U.S.

and culture-of-origin competence were also associated with higher scores on the MEIM

ethnic identity scale.

Subjective Well-Being

Two measures of Subjective Well-Being were used to capture different aspects of

the participant's well-being. One of the Subjective Well-Being measures was the

Schwartz Outcome Scale-10-E (SOS-10-E), a scale translated by Rivas-Vazquez et al.

(2001) that taps broad domains of psychological health and demonstrates strong

divergent correlations with measures of psychopathology and strong convergent

 65

correlation with measures of Subjective Weil-Being. This self-report scale contains 10

items scored on a 6-point Likert scale ranging from "never" to "all the time or almost all

the time." The higher scores indicate higher levels of well-being.

The original SOS-10 was normed and validated using multiple samples, which

included psychiatric patients in a hospital setting, college students, and outpatients (Blais

et al. 1999; Young et al. 2003). Test-retest reliability was established using multiple

samples of undergraduate students over a one-week period, the typical correlation

between the two administrations was .86 (p < .001). Concurrent validity was established

by comparing the SOS-10 scores of 193 undergraduates to scores on the Rotter

Incomplete Sentence Blank (RISB; Lah, 1989), a measure of conflict or maladjustment.

The two measures correlated significantly (r= -.56, p < .001), with participants who

scored high on well-being and lower on the measure of maladjustment. Another study

that established concurrent validity was done by comparing the SOS-10 scores of 43

counseling center clients to scores on the Outcome Questionnaire (OQ-45; Wells, et al.

1996), a measure of client distress. The two measures correlated significantly (r= -.84,/?

< .01). The internal consistency of this measure was calculated by combining the

subjects of the three above mentioned studies, and obtained a Cronbach's a of .90.

Analysis of the translation of the SOS-10 to SOS-10-E was conducted with 100

foreign born bilingual volunteers (Rivas-Vazquez et al. 2001). English and Spanish

version scale scores correlated at .86 (p< .001). No significant correlations were found

between either the English or Spanish versions with the participant's age or acculturation

level as measured by the Hispanic Acculturation Scale (HAS; Marin et al. 1987). The

test-retest correlation was .86 with an average interval retest of 7 days. The original
English version SOS-10 has significant validity data, which is expected to transfer to the

SOS-10-E given the strong correlations between the 10 items (r=.75 to .98) and the

correlation between the two measures. The following includes examples of questions in

this measure and their translation into Spanish. English version, "I am generally satisfied

with my psychological health." Spanish translation, "Me siento generalmente

satisfecho(a) con mi salud mental."

The other measure of Subjective Weil-Being used was the Psychological General

Weil-Being Schedule (PGWBS)-Spanish translation (Dupuy, 1984). This measure

captures both negative and positive intrapersonal affective and emotional well-being as

well as distress experienced within the past month (see Appendix B). This is a generic

quality of life measure that assesses physical, cognitive, affective and social economic

domains (Bech, 1995). The PGWBS is a 22 item index, with six subscales, which

include anxiety, depressed mood, positive well-being, self-control, general health, and

vitality. The item response ranges from 0 to 5 points, with lower points reflecting

negative answers and higher points reflecting positive answers. The possible scores

range from 0 to 110, with the elevated scores reflecting greater well-being. This measure

was translated by this writer into Spanish using the Back Translation Method and the

Team or Panel Method (see Instrument Translation Procedure section).

The PGWBS was developed in the normal population and was validated on a

national United States sample of 6,913, of which 240 reported Mexican or Hispanic

ethnicity (Dupuy, 1984). This measure has been underutilized among Latino samples.

The index of normative values is 82.2 ± 15.7 (mean ± standard deviation), while the

mean for mental health clients at intake is 45.78 ± 24.02 (mean ± standard deviation). A
number of studies based on community samples, aged 14 to 75, report high internal

consistency for the individual subscales (a= .72 to .88) and overall index (a= .90 to .94).

Dupuy (1984) found evidence of the PGWBS's concurrent validity through correlational

analysis of fourteen mental health scales (e.g. Beck Depression Scale; CES; MMPI,

depression scale; Psychiatric Symptoms Scale, depression and anxiety subscales). The

correlations ranged from r = .52 to r = .80 with these scales (Dupuy, 1984). Bech (1993)

found the PGWBS to have discriminating validity in a medical setting. Croog, Levine, &

Testa (1986) compared the PGWBS to eleven other well-being and quality of life

measures and found the PGWBS was the most sensitive to assessing quality of life

among individuals receiving medical treatment for hypertension.

This scale has been used with multiple populations such as a national probability

sample, military wives, Latino adolescents, and African American college students

(Dupuy, 1994; Funk, 1993). It has also been used with clinical populations (Borup &

Unden, 1994). It had good predictive validity as it was able to predict relapse of

depression among mood disordered patients participating in long term treatment. In

another clinical study, the PGWBS was used to assess treatment progress and success.

Borup and Unden (1994) showed that individuals diagnosed with major depressive

disorder and alcoholism obtained PGWBS scores in the normal range after completing

six months of psychotropic medication treatment.

For the purpose of this study, the PGWBS was translated into Spanish, and

therefore has not yet been validated with a Spanish speaking Hispanic sample.
 68

Demographic Data

A demographic questionnaire developed for this study was used to assess

participant information (refer to Appendix C & D). Questions were written in Spanish

and English and ask participants to report their age, gender, country of origin, number of

years living in the United States, marital status, educational attainment, and employment

status.

Informed Consent

All participants were given an informed consent form in Spanish or English

language that describes the purpose of the study and their rights as study participants (see

Appendix E & F). The informed consent form followed the HIPP A and American

Psychological Association's guidelines, and the Internal Review Boards of NYU School

of Medicine, Bellevue Hospital and Fordham University's guidelines of ethical treatment

of study participants.

The participants were informed that they had the right to withdraw from the study

at any time without penalty and that all their responses are confidential. The form

provided the name of the researcher and the University, and a telephone number where

the participants could contact the principal or supervising investigator as well as the IRB

office if they had questions. The questionnaire packets were assigned a code number to

ensure confidentiality.
 69

Operational Hypotheses

The following operational hypotheses were tested:

1. Subjective Weil-Being scores, as measured by the SOS-10-E, would be

predicted by Stable personality factors of Extraversion, Openness to

Experience, and Neuroticism from the BFI.

a. Subjective Well-Being scores, as measured by the SOS-10-E, would

be predicted by higher Extraversion and Openness to Experience and

lower Neuroticism scores from the BFI.

b. Subjective Well-Being scores, as measured by the PGWBS, would be

predicted by higher Extraversion and Openness to Experience and

lower Neuroticism scores from the BFI.

2. Subjective Well-Being would be predicted by stable PM, beyond the effects of

the FFM traits. While controlling for the effects of FFM, high PM levels

would positively predict Subjective Well-Being.

a. Subjective Well-Being scores, as measured by the SOS-10-E, would

be predicted by higher scores on the PM Scale.

b. Subjective Well-Being scores, as measured by the PGWBS, would be

predicted by higher scores on the PM Scale.

3. Subjective Well-Being scores would be predicted by AMAS-ZABB

Acculturation subscale levels, beyond FFM and PM. Acculturation would be

assessed in two dimensions, U.S.-American (ACU total) and culture-of-origin

competence (ACL total). The three subscales (language competence, identity

competence, culture competence) from the U.S. Acculturation competence

 70

dimensions were added together, the mean was then centered to create the

ACU competence composite score (U.S.-American Acculturation competence

dimension). The same procedure was followed to create the ACL competence

composite score (Latino competence dimension). While controlling for the

effects of FFM and PM, higher scores on both competence dimensions (U.S.=

ACU total and Latino= ACL total competence) at the same time (according to

a bipolar and bilinear model) would positively predict Subjective Well-Being.

a. Subjective Well-Being scores, as measured by the SOS-10-E, would

be predicted by higher U.S. Acculturation (ACU) competence

composite scores and Latino Acculturation (ACL) competence

composite scores from the AMAS-ZABB.

b. Subjective Well-Being scores, as measured by the PGWBS, would be

predicted by higher U.S. Acculturation (ACU) competence composite

scores and Latino Acculturation (ACL) competence composite scores

from the AMAS-ZABB.

4. Acculturation would be assessed in two dimensions, U.S.-American (ACU

total) and culture-of-origin competence (ACL total), which consist of the

centered mean scores from scales of cultural competence, cultural identity and

language competence from the AMAS-ZABB. An interaction effect created

by multiplying the two centered composite scores (ACL* ACU) between the

two Acculturation dimensions would be evaluated for prediction of higher

levels of Subjective Well-Being.

 71

a. Subjective Well-Being scores, as measured by the SOS-10-E, would

be predicted by an interaction effect between the two Acculturation

dimensions (ACL*ACU) from the AMAS-ZABB.

b. Subjective Well-Being scores, as measured by the PGWBS, would be

predicted by an interaction effect between the two Acculturation

dimensions (ACL*ACU) from the AMAS-ZABB.

 CHAPTER III: RESULTS

The data analyses for the current study were organized into two sections: (a)

descriptive statistics followed by (b) inferential statistics to evaluate the previously

outlined hypotheses. The first section of this chapter consists of descriptive analyses,

including frequencies, means, standard deviations, kurtosis and skewness of the measures

utilized. The second section of this chapter includes inferential statistics to evaluate the

reliability of the measures, correlation analyses, t-tests, chi-square, hierarchical

multivariate regression analyses and post hoc analyses.

Before analysis took place, the data was examined for data entry accuracy,

missing values and assumptions of normality. All data were analyzed using SPSS,

Version 13.

Descriptive Statistics

Measure Descriptives

The scale descriptive statistics are shown in Table 5. The means and standard

deviations for most scales utilized in this study performed as expected. The BFPs

Openness to Experience subscale demonstrated a similar mean and standard deviation as

compared to prior reliability research (from a Hispanic non-college adult sample, rc=139).

In contrast, the Extraversion subscale was one standard deviation below the normed mean

(M=3.5, SD=J) and the Neuroticism subscale was one standard deviation above the

normed mean (M=2.6, SX>=.8) (Benet-Martinez & John, 1998). The PM Scale's mean

and standard deviation was similar when compared to prior research of clinical samples

(Conte et al. 1995). The AMAS-ZABB's U.S. Acculturation and Latino Acculturation

competence composite scales demonstrated similar means and standard deviations as

72
 73

Table 5

Scale Descriptive Statistics

Variable Mean SD Range Alpha

Min Max

SOS-10-E 3.5 1.6 0 6 .90

PGWBS 49.6 22.5 4 100 .93

PM 132 15.8 76 168 .78

Extraversion 2.6 .9 1 5 .66

Neuroticism 3.5 1 1 5 .80

Openness to Experience 3.6 .8 1 5 .71

ACU Tot 2.4 .7 1 4 .94

ACUI 2.9 1.1 1 4 .93

ACUL 2.1 .8 1 4 .97

ACUC 2.2 .9 1 4 .93

ACL Tot 3.5 .3 2.2 4 .81

ACLI 3.7 .5 1 4 .88

ACLL 3.9 .3 2.8 4 .94

ACLC 2.8 .7 1.5 4 .81

ACL*ACU -.03 .23 -.88 .74

Notes: N = 100; SOS-10-E = Schwartz Outcome Scale, a general psychological health measure; PGWBS =
Psychological Well-Being Schedule, a positive and negative affect symptom measure; PM = Psychological Mindedness
Scale; ACU Tot = U.S. Acculturation Composite Score; ACUI = U.S. Identity Subscale; ACUL = English Language
Subscale; ACUC = U.S. Culture Subscale; ACL Tot = Latino Acculturation Composite Score; ACLI = Latino Identity
Subscale; ACLL = Spanish Language Subscale; ACLC = Latino Culture Subscale; ACL*ACU= Interaction term of
U.S. & Latino Acculturation centered composite scores.

compared to prior community sample research (Zea et al. 2003). The interaction term

(ACL*ACU) ranged from 3.73 to 15.11, with no participants in the marginalism range
 74

(1-2) and 10% («= 10) in the biculturalism range. The majority of the participants' U.S.

and Latino competence scores (90%; n= 90) were in the middle range. Scores in this

middle range require additional research to understand their acculturation level

significance.

The SOS-10-E's mean and standard deviation was lower when compared to the

validation research of this measure's translation (Rivas-Vazquez et al. 2001). This

study's sample was two standard deviations below the mean when compared with the 100

foreign born bilingual non-clinical participants used to norm the SOS-10-E translation

(M=5.1, iSD=.71). The SOS-10-E's lower scores are likely due to this clinical sample

being more distressed than the non-clinical validation sample.

The mean and standard deviation of the Spanish version of the PGWBS,

translated for this study, were similar when compared to the mean and standard deviation

of clinical samples that utilized the English PGWBS (Dupuy, 1984). The PGWBS means

for this study was similar when compared to prior research for mental health clients at

intake.

To assess the function of each scale, the internal consistency reliability

(Cronbach's a) was evaluated. The BFI, PM Scale, SOS-10-E, and PGWBS functioned

as expected. The AMAS-ZABB U.S. Acculturation and Latino Acculturation

competence scales both functioned as expected. In this sample, participants were most

likely to endorse items indicating high proficiency in Spanish Language and strong

identification to their Latino identity. The Spanish Language and Latino Identity

subscales had similar SD and mean to the normative sample, yet were found to be

negatively skewed (-3.20 and -2.74 respectively). The negative skew of the Spanish
 75

Language and Latino Identity subscales was likely due to the sample composition of

largely immigrant participants similar to one of the normative samples used. This

negative skew decreased the variability of the Spanish Language and Latino Identify

subscale score; but a logarithmic transformation was not performed given this sample's

scores were similar to the normative sample.

Translated Measures

The English PM Scale Cronbach's alpha was .86, the PM Scale-Spanish

translation alpha was .78, which was lower by .08 points, yet was still within acceptable

reliability range. This study translated the PGWBS into Spanish and the alpha calculated

was .93, similar to the reliability obtained for the English measure in prior research. This

supports the argument that the PM Scale-Spanish translation and the PGWBS-Spanish

translation are reliable measures.

Correlations of Demographics with Dependent Variables

A Pearson correlation analysis was conducted between the demographic variables

and the dependent variables. The number of years living in the U.S. was significantly

correlated with the Subjective Well-Being measure PGWBS (r = -.25, p< .01), but not

with the SOS-10-E. Suggesting that the longer the participant's lived in the U.S. the

lower their reported Subjective Well-Being. The number of years living in the U.S. was

controlled for in subsequent inferential analysis. The number of months in previous

therapy was significantly negatively correlated with Subjective Well-Being measure

SOS-10-E (r = -.22, p< .01), but not correlated with PGWBS. Suggesting that the longer

the participants had been in therapy, the lower their reported psychological health and

Subjective Well-Being. One participant outlier endorsed 84 months in previous therapy;

when this outlier was removed from the analysis, this demographic variable was no
 76

longer correlated to SOS-10-E. Subsequent inferential analyses for SOS-10-E were

performed with 99 participants.

Correlations of Independent and Dependent Variables

The correlations between independent and dependent variables are presented in

Table 6. The Pearson correlation analyses were conducted with all 100 participants. The

dependent measures were significantly correlated with each other (r = .68,/K.Ol).

Suggesting that the SWB measures tapped related constructs. The independent

personality variables were also significantly correlated with the dependent variables

(SOS-10-E and PGWBS); Extraversion (r = .35,/X.Ol; r = .42.,/K.01 respectively),

Openness to Experience (r = A\,p<.0\;r = .35,;?<.01 respectively), and negatively

correlated to Neuroticism (r = -.57,p<.0l;r = -.52,p<.0l respectively). The higher

levels of Extraversion and Openness to Experience were associated with higher

Subjective Weil-Being scores. PM was correlated significantly to SOS-10-E and

PGWBS (r = 39,p<.0\; r = .41,/K.Ol respectively). Psychological Mindedness was

associated with higher Subjective Well-Being. The two stable personality independent

variables (FFM and PM) were significantly correlated with each other, PM was positively

correlated to Extraversion (r = A4,p<.0\), to Openness to Experience (r = 36,p<.05),

and negatively correlated to Neuroticism (r = -23,p<.05). Higher levels of

Psychological Mindedness were associated with higher Extraversion and Openness to

Experience and lower Neuroticism scores.

The U.S. Acculturation competence composite and subscale scores were not

significantly correlated with SOS-10-E. Only the Latino Acculturation subscales and

composite scores were related to SWB. The Latino Acculturation subscales of Spanish

Language (r = .37,/»<.01), and Cultural competence (r = .21,/K.05), and the Latino

 Table 6
Correlations between Independent and Dependent Variables

Variable SOS-10-E PGWBS PM N O ACUTot ACUI ACUL ACUC ACL Tot ACLI ACIX ACLC ACU*ACL

SOS-10-E

PGWBS .68**

PM 39** 41**

E 35** 42** 44**

N . 57** . 52** -.23** - 47**

O .41** .35** .36** .47** -.29** -

ACU Tot -.02 -.04 .16 .22* .01 .21* -

ACUI .04 .02 .06 .06 .02 -.07 .70** -

ACUL -.10 -.11 .12 .24* .09 .29** .80** .18 -

ACUC .01 -.02 .23* .25* -.10 .32** .86** 31** .80** -

ACL Tot .28** .18 .14 .02 -.28** .10 -.13 -.06 -.17 -.08 -

ACLI .08 -.05 -.21* -.23* .03 -.20* -.26** -.09 -.23* -.33** .63** -

ACLL .37** .22* .13 -.04 -.28** .12 -.11 .11 -.31** -.12 .47** .08 -

ACLC .21* .22* .34** .24* -.33** .27** .08 -.06 .06 .21* 77** .06 .24*

ACU*ACL .07 .02 .02 .-.09 .05 .-.09 -.11 -.10 -.07 -.09 .31** .38** .14 .08

Notes: N = 100; SOS-10-E = Schwartz Outcome Scale, a general psychological health measure; PGWBS = Psychological Well-Being Schedule, a positive and negative affect
symptom measure; PM = Psychological Mindedness Scale; ACU Tot = U.S. Acculturation Composite Score; ACUI = U.S. Identity Subscale; ACUL = U.S. Language Subscale;
ACUC = U.S. Culture Subscale; ACL Tot = Latino Acculturation Composite Score; ACLI = Latino Identity Subscale; ACLL = Latino Language Subscale; ACLC = Latino
Culture Subscale; ACU*ACL= Interaction between U.S. Acculturation Composite Score and Latino Acculturation Composite Score; *p< .05, **p< .01, two-tailed
 78

Acculturation composite total (r = .28,/?<.0l) were significantly correlated to SOS-10-E.

Therefore, higher scores on Latino Acculturation competence were associated with

higher Subjective Well-Being scores.

The Latino Acculturation subscales of Spanish Language (r = .22,p<.05), and

Cultural competence (r = 22,p<.05) were correlated significantly with the PGWBS.

Unlike the Subjective Well-Being measure of SOS-10-E, PGWBS was not correlated to

the Latino Acculturation cumulative scale. PGWBS was not correlated with the U.S.

Acculturation subscale and composite scores. Only Latino Acculturation competence

subscales were related to Subjective Well-Being.

Inferential Statistics

In this study, the first hypothesis was that stable personality traits are predictive of

Subjective Well-Being. Hypothesis 2 was that Psychological Mindedness was predictive

of Subjective Well-Being. Hypothesis 3 was that Acculturation level predicts Subjective

Well-Being beyond the stable personality traits and Psychological Mindedness.

Hypothesis 4 stated that an interaction effect between the two Acculturation composite

scores (ACL*ACU) would be evaluated and be predictive of higher Subjective Well-

Being.

The principal analysis used in this study to test all hypotheses was a hierarchical

multiple regression. In order to control for the correlation effects of the number of years

in the U.S., the demographic variable was entered as a first step in the regression. The

three personality traits (FFM) were entered as the second step in the hierarchical

regression, the PM variable was entered as a third step, both the U.S. and Latino

Acculturation centered composite totals were entered as a fourth step, the Acculturation
 79

interaction term was entered as a fifth step with the SOS-10-E entered as the dependent

variable. Based on the mixed findings in the Acculturation literature, the Acculturation

interaction variable was entered separately from the Acculturation composite variables.

A separate hierarchical regression analysis was conducted for PGWBS using procedures

detailed above.

Beta weights were evaluated in order to compare the relative influence of each

variable to the overall variance.

Hypotheses 1. The first hypothesis predicted that low Neuroticism, high Extraversion,

and high Openness to Experience would predict SWB. This hypothesis was evaluated by

controlling the number of years in the U.S. as a first step, the FFM traits were entered

into the second step of the hierarchical regression analyses, with SOS-10-E as the

dependent measure of SWB. The same procedures were followed in the second

hierarchical regression with the PGWBS as the dependent measure of SWB.

1 A) Subjective Weil-Being scores, as measured by the SOS-10-E would be predicted by

higher Extraversion and Openness to Experience and lower Neuroticism on the

BFI.

Regression coefficients are presented in Table 7. The first step controlling for

years in the U.S. was not significant, R2= .04, F (1, 97) = 3.80;p = .054. The second step

including the three personality traits was significantly predictive of SWB, R2= .38, F (4,

94) = 14.40;/) < .001 and (R2 step 1= .04, R2 step 2= .38; AR2 =.34). The beta weights for

each personality trait are Neuroticism (P = -.50, p < .001) and Openness to Experience (|3

= 24, p = .012). The beta weight for Extraversion was not significant. The higher scores

of Openness to Experience predicted higher SOS-10-E scores, while higher Neuroticism

 80

scores predicted lower SOS-10-E scores. The personality traits of Neuroticism and

Openness to Experience account for 34% of the variance. This hypothesis was partially

supported.

IB) Subjective Weil-Being scores, as measured by the PGWBS, would be predicted by

higher Extraversion and Openness to Experience and lower Neuroticism on the

BFI.

Regression coefficients are presented in Table 8. The first step controlling for

years in the U.S. was significantly predictive of SWB, R^ .06, F ( l , 98) = 6.42;/? <.013.

The second step of the regression including the three personality traits, was significantly

predictive of SWB, R2= .35, F (4, 95) = 12.74;/? < .001 and (R3 step 1= .06, R2 step 2=

.35; AR2 =.29). The beta weights were only significant for Years in U.S. (P = -.25,p =

.013) and Neuroticism (P = -.38,/? < .001), and were not significant for Openness to

Experience, and Extraversion. The BFI Neuroticism scores account for most of the

predictive power of FFM on Subjective Well-Being. The personality trait of Neuroticism

accounted for 29% of the variance. This hypothesis was partially supported.

Hypothesis 2. Subjective Well-Being scores would be predicted by Stable Psychological

Mindedness, beyond the effect of the FFM traits of Extraversion, Openness to

Experience, and Neuroticism.

2A) Subjective Well-Being scores, as measured by the SOS-10-E, would be predicted by

higher scores on the PM Scale.

Hierarchical regression analysis was conducted for SOS-10-E using procedures

detailed above. Regression coefficients are presented in Table 7. In this step including

PM was significant, R2= .43, F ( 5 , 93) = 13.97;/? = .006. The R-squaredindicates that
 81

Psychological Mindedness is predictive of Subjective Weil-Being beyond the FFM to a

small degree (R2 step 2= .38, R2 step 3= .43; AR2 =.05). The relative predictive power of

the FFM and PM was inspected by evaluating standardized beta weights. The beta

weights for step 3 were significant for Neuroticism (P = -.50, p < .001), Openness to

Experience (p = . 18, p = .047), and PM (P = .25, p = .006). The beta weights were not

significant for Extraversion. Psychological Mindedness accounted for 5% of the

variance. This hypothesis was supported.

2B) Subjective Weil-Being scores, as measured by the PGWBS, would be predicted by

higher scores on the PM Scale.

Hierarchical regression analysis was conducted for PGWBS using procedures

detailed above. Regression coefficients are presented in Table 8. This third step in the

regression was significant, R2=z .40, F (5, 94) = 12.26;/? = .009. Based on the R-

squared, Psychological Mindedness is predictive of Subjective Weil-Being beyond the

FFM again to a small degree (R2 step 2= .35, R2 step 3= .40; AR2 =.05). The relative

predictive power of the FFM and PM was inspected by evaluating standardized beta

weights. The beta weights for step 3 were significant for Neuroticism (P = -.38, p < .001)

and PM (P = .24, p = .009). The beta weights were not significant for Openness to

Experience, and Extraversion. Psychological Mindedness accounted for 5% of the

variance. This hypothesis was supported.

Hypothesis 3. Subjective Well-Being scores would be predicted by higher scores on both

U.S. and Latino Acculturation competence dimensions at the same time, while

controlling for the effects of FFM and PM. The three subscales (Language, Identity,

Culture) from the U.S. Acculturation competence dimensions were added together, the
 82

mean was then centered to create the ACU competence composite score (U.S.-American

Acculturation competence dimension). The same procedure was followed to create the

ACL competence composite score (Latino competence dimension).

3A) Subjective Weil-Being scores, as measured by the SOS-10-E, would be predicted by

hiRher U.S. Acculturation competence composite score and Latino Acculturation

competence composite score on the AMAS-ZABB.

This hypothesis was evaluated by conducting a hierarchical regression analysis of

SOS-10-E using procedures detailed above. Regression coefficients are presented in

Table 7. This fourth step in the regression was not significant, R2= .44, F (7, 91) =

10.22; p- .41. The R-squared shows that ACU and ACL competence composite scores

do not significantly predict Subjective Well-Being beyond the FFM and PM (R2 step 3=

.43, R2 step 4= .44; AR2 =.01). The relative predictive power of the FFM, PM, and

Acculturation composite scores were inspected by evaluating standardized beta weights.

The beta weights for step 4 were significant for Neuroticism (P = -.46, p < .001),

Openness to Experience (p = .19, p = .04), and PM (P = .25, p = .008). The beta weights

were not significant for Extraversion, ACU and ACL competence composite scores. This

hypothesis was not supported.

3B) Subjective Well-Being scores, as measured by the PGWBS, would be predicted by

higher U.S. Acculturation competence composite score and Latino Acculturation

competence composite score on the AMAS-ZABB.

This hypothesis was evaluated by conducting a hierarchical regression analysis of

PGWBS using procedures detailed above. Regression coefficients are presented in Table

8. This fourth step in the regression was not significant, R*= .40, F (7, 92) = 8.65;p =
 83

.84. The R-squared found that Acculturation is not predictive of Subjective Weil-Being

when assessed by the PGWBS beyond the FFM and PM (R2 step 3= .40, R2 step 4= .40;

AR2 =.002). The relative predictive power of the FFM, PM, and Acculturation subscale

scores were inspected by evaluating standardized beta weights. The beta weights for step

4 were significant for only Neuroticism (P = -.38,;? < .001) and PM (P = .25, p = .009).

They were not significant for Openness to Experience, Extraversion, ACU and ACL

competence composite scores. This hypothesis was not supported.

Hypothesis 4. Acculturation was assessed in two dimensions, U.S.-American (ACU

subscale totals) and culture-of-origin competence (ACL subscale totals). An interaction

variable was created by multiplying the centered ACL and ACU competence composite

scores (ACL* ACU) from the AMAS-ZABB. An interaction effect between the two

Acculturation dimensions was evaluated for both SWB measures.

4A) Subjective Weil-Being scores, as measured by the SOS-10-E, would be predicted by

an interaction effect between the two Acculturation dimensions (ACL* ACU)

from the AMAS-ZABB.

This hypothesis was evaluated by conducting a hierarchical regression analysis of

SOS-10-E using procedures detailed above. Regression coefficients are presented in

Table 7. This fifth step in the regression was not significant, R2- .44, F (8, 90) = 9.02; p

= .38. The R-squared shows that the created Acculturation interaction term was not

predictive of Subjective Well-Being beyond the FFM, and PM (R2 step 4= .440, R2 step

5= .445; AR2 =.005). The relative predictive power of the FFM, PM, Acculturation

competence composite scores, and ACL*ACU were inspected by evaluating standardized

beta weights. The beta weights for step 5 were significant for Neuroticism (P = -.47, p <
 84

.001), Openness to Experience ((3 = .20,p = .038), and PM (p = .24,p = .009). The beta

weights were not significant for Extraversion, ACU and ACL competence composite

scores, and the ACL* ACU interaction term. This hypothesis was not supported.

Table 7

Multiple Regression Predicting Subjective Well-Being for SOS-10-E by Personality

Traits, Psychological Mindedness and Acculturation

Variable AR1 df B ~SEB ~p

Stepl
Number ofyears in U.S. .04 1,97 -.02 .01 -.19

Step 2

FFM .34*** 4,94

Openness to Experience .45** .17 .24**

Extraversion -.03 .18 -.02

Neuroticism -.78*** .14 -.50***

Step 3
Psychological Mindedness .05** 5,93 1.12** .40 .25**
Step 4

ACU Competence Composite .01 7,91 -.15 .23 -.07

ACL Competence Composite .01 .45 .39 .10

Step 5
ACL* ACU .00 8,90 .51 .57 .08
Notes: N = 99; *p < .05, **p < . 0 1 , ***p < .001. SOS-10-E = Schwartz Outcome Scale, a
general psychological health measure; FFM = Five Factor Model, Openness to Experience, Extraversion &
Neuroticism composite; ACU Competence Composite= U.S. Acculturation centered composite score of all 3
subscales; ACL Competence Composite= Latino Acculturation centered composite score of all 3 subscales;
ACL*ACU= Interaction term of U.S. & Latino Acculturation composite scores

4B) Subjective Weil-Being scores, as measured by the PWGBS, would be predicted by

an interaction effect between the two Acculturation dimensions (ACL* ACU')

from the AMAS-ZABB.

 85

A hierarchical regression analysis was conducted for PGWBS as dependent

variables by using procedures detailed above. Regression coefficients are presented in

Table 8. The results were not significant for PGWBS, R2= .40, F (8, 91) = 7.54;/? = .62,

and was reflected by the small change in R2 from step 4 to step 5 (R2 step 4= .397, R2 step

5= .399; AR2 =.002). The R-squared indicates that the Acculturation interaction term is

not predictive of Subjective Well-Being. The relative predictive power of the FFM, PM,

Table 8

Multiple Regression Predicting Subjective Weil-Being for PGWBS by Personality Traits,

Psychological Mindedness and Acculturation

Step Variable IF2 df B SEB ~B

Stepl
Number of years in U.S. .06:
1,98 -.39* .15 -.25*
Step 2
FFM .29:* * *
4,95
Openness to Experience
3.98 2.50 .15
Extraversion
3.89 2.67 .15
Neuroticism
-8.62*** 2.14 _38***
Step 3
Psychological Mindedness .05:** 5,94 15.57** 5.85 .24**

Step 4
ACU Competence Composite .00 7,92 -1.98 3.39 -.00

ACL Competence Composite .00 -.25 5.89 .00

Step 5
ACL*ACU .00 8,91 4.21 8.52 .04

Notes: N = 100; *p < .05, **p < . 0 1 , ***p < .001. SOS-10-E = Schwartz Outcome Scale, a
general psychological health measure; FFM = Five Factor Model, Openness to Experience, Extraversion &
Neuroticism composite; ACU Competence Composite=U.S. Acculturation centered composite score of all 3
subscales; ACL Competence Composite= Latino Acculturation centered composite score of all 3 subscales;
ACL*ACU= Interaction term of U.S. & Latino Acculturation composite scores
 86

Acculturation competence composite scores, and ACL*ACU were inspected by

evaluating standardized beta weights. The beta weights for step 5 were significant for

Neuroticism (p = -.38,/? < .001) and PM (0 = 25,p < .01). The beta weights were not

significant for Openness to Experience, Extraversion, ACU and ACL competence

composite scores, and the ACL* ACU interaction term. This hypothesis was not

supported.

Post Hoc Analyses

Previous Acculturation research has found mixed results regarding its predictive

power of Subjective Well-Being. The lack of clarity might be due to researchers use of

different measures of Acculturation. This study used an Acculturation measure that

allowed for exploration of independent predictors to distinguish which subscales were

most influential in predicting Subjective Well-Being (Language, Identity or Cultural

competence). Based on trends in the data and unexpected findings with this culturally

unique clinical sample, additional analyses were conducted. First, correlations between

PM and demographic variables were conducted. Pearson product-moment correlations

for the Personality and Acculturation subscales were conducted to explore their

interrelations. Finally, the Acculturation subscales were analyzed independently for

correlations to demographic variables, as well as stepwise and hierarchical regressions

were conducted.

Contrary to prior research (McCullum & Piper, 1997; Conte et al. 1990; Conte &

Ratto, 1997), PM was significantly correlated to the education of the participants (r = .26,

p<.05). Higher levels of Psychological Mindedness were associated with higher levels of

education. Additionally, the independent personality variables were significantly

 87

correlated with many of the Acculturation competence subscales and composite scores.

Refer to Table 6 for correlation values. The PM score was significantly correlated to

U.S. Culture (r = .23,/X.05), Latino Culture (r = .34,p<.0\% and Latino Identity (r = -

.2l,p<.05). Therefore, higher Psychological Mindedness was associated with higher

competence in U.S. Culture and Latino Culture, but lower levels of Latino Identity.

Extraversion was significantly correlated to English Language (r = .24,p<.05),

U.S. Culture (r = .25.,p<.05), Latino Culture (r = 24,p<.05), and Latino Identity (r = -

.23,/?<.05). Higher scores of Extraversion were related to higher competence in English

Language and Culture, as well as Latino Culture and Identity. Extraversion was

significantly correlated to the U.S. Acculturation competence composite score (r = .22,

p<.05), but not to the Latino competence composite score. Higher Extraversion scores

were associated with higher U.S. Acculturation competence.

Openness to Experience was significantly correlated to English Language (r =

.29,p<.01), U.S. Culture (r = 32.,p<M), Latino Culture (r = .27,p<.0l), and Latino

Identity (r = -.20,/?<.05). Higher Openness to Experience scores were associated with

higher competence in English Language, U.S. Culture, and Latino Culture, but lower

Latino Identity. Openness to Experience was significantly correlated to the ACU (U.S.)

competence composite score (r = .21,/?<.05) but not to the ACL (Latino) competence

composite score. Higher Openness to Experience scores were associated with higher

U.S. Acculturation competence.

Neuroticism was only significantly correlated to the Spanish Language (r = -.28,

p<.0\), Latino Culture (r = -.33,p<.0\), and the Latino Acculturation competence

composite score (r = -. 2S,p<.0\). Higher Neuroticism scores were associated with

 88

lower competence in Spanish Language and Culture, and Latino Acculturation

competence in general.

The mixed predictive results of the Acculturation scores led to further statistical

exploration of the Acculturation subscales. Correlation analyses were conducted between

Acculturation scores and demographic variables. The number of years in the U.S. was

related to both ACL competence composite (r = -.21,/?<.05) and ACU competence

composite (r = .56,/?<.01). Therefore, higher scores on Latino acculturation competence

were associated with less years in the United States, and higher scores on the U.S.

acculturation competence were associated with being in the U.S. a longer amount of time.

Both age and level of education were related to the ACU competence composite (r = .26,

p<.0l; r = .27,/?<.01 respectively). Participants who were older and more educated

reported higher scores on the U.S. competence composite. Based on six independent t-

tests, significance was not detected by gender. None of the U.S. Acculturation and

Latino Acculturation subscale scores were significantly correlated with income.

Separate stepwise regression analyses were conducted for the dependent variables

SOS-10-E and PGWBS. The demographic variable and all six Acculturation competence

subscale scores were entered into the stepwise regression as one step in order to ascertain

which subscales contributed most to the prediction of SOS-10-E and PGWBS.

Regression coefficients are presented in Table 9 for SOS-10-E and Table 10 for PGWBS.

Contrasting the results from the hierarchical regression for SOS-10-E, the Spanish

Language subscale was significant, R2= .15, F ( l , 97) - 16.91;/? < .001 (p = .39,p <

.001).
 89

Table 9

Stepwise Regression of Acculturation Subscales Predicting Subjective Well-Being for

SOS-10-E

Variable AR2 ~df B SEB /?

Number of Years in U.S. 1^97 ^15

U.S. & Latino Acculturation subscales

U.S. Identity .01

English Language -.01

U.S. Culture .04

Latino Identity .06

Spanish Language .15*** 2.26*** .55 39***

Latino Culture . 13
Notes: N= 99; ***p < .001. SOS-10-E = Schwartz Outcome Scale, a general psychological health
measure.

Again, dissimilar to the results from the hierarchical regression for PGWBS the

demographic variable Years in the U.S. was significant, R2= .06, F (1, 98) = 6.42; p <

.013 (P = -.25, p < .05) and the Spanish Language subscale was significant, R2= .04, F (2,

97) = 5.29; p < .007 (|3 = .19,/? < .05). No other Acculturation subscales were

significant.

Based on these step-wise regression results, the original hierarchical regression

model was used to test whether Spanish Language, not the Acculturation composite

scores, can predict SWB beyond the effects of personality. The Spanish Language

subscale score was entered as the fourth step in two separate hierarchical regressions for

each dependent variable (Refer to table 11 for SOS-10-E and Table 12 for PGWBS
 90

regressions). The first three steps of the regression remained the same as reported

previously when regressed upon SOS-10-E, the fourth step in the regression was

significant, R2= .68, F (6, 92) - 13.37;/? = .014. Based on the R-squared, Spanish

Language is predictive of Subjective Well-Being beyond the FFM and PM, and

accounted for 4% of the variance (R2 step 3= .43, R2 step 3= .47; AR2 =.04).

Table 10

Stepwise Regression Predicting Subjective Weil-Being for PGWBS by Acculturation

Subscales

Step Variable AR' df B S~E~B /?

Number of Years in U.S. ^06* 1^98 06* JL5 ^23*

U.S. & Latino Acculturation subscales

U.S. Identity .14

English Language .06

U.S. Culture .13

Latino Identity -.09

Spanish Language .04* 2,97 16.47* 8.27 .19*

Latino Culture .14

Notes: N= 100; *p < .05. PGWBS = Psychological General Well-Being Schedule, a positive and
negative affect symptom measure.

Spanish Language was not significant when PGWBS was used as the dependent

measure of SWB, R2= .40, F (6, 93) = 10.27; p = .45, (R2 step 3= .05, R2 step 3= .40;

AR2 =.004). A possible reason why Spanish Language was predictive of Subjective Well-

Being for one measure of SWB and not the other is that each measure tapped different

well-being domains. The SOS-10-E tapped broad domains of psychological health, while
 91

the PGWBS captured both negative and positive intra-personal affective and emotional

well-being, as well as distress experienced within the past month.

Table 11

Multiple Regression Predicting Subjective Weil-Being for SOS-10-E by Personality

Traits, Psychological Mindedness and Spanish Language

Step Variable ~KR2 of B SEB ~J~

Stepl
Number of years in U.S. .04 1,97 -.02 .01 -.19

Step 2

FFM .34*** 4,94

.45** .17 .24**
Openness to Experience
-.03 .18 -.02
Extraversion
_ yg*** .14 -.50*=
Neuroticism

Step 3
Psychological Mindedness .05** 5,93 1.12** .40 .25**
Step 4
Spanish Language .04* 6,92 1.22* .49 -.21*

Step 5
ACL*ACU .00 7,91 .51 .52 .08

Notes: N = 99; *p < .05, **p < . 0 1 , ***p < . 0 0 1 . SOS-10-E = Schwartz Outcome Scale, a
general psychological health measure; FFM = Five Factor Model, Openness to Experience, Extraversion &
Neuroticism composite; Spanish Language=Spanish Language Competence Subtest; ACL*ACU= Interaction term
of U.S. & Latino Acculturation composite scores
 92

Table 12

Multiple Regression Predicting Subjective Weil-Being for PGWBS by Personality Traits,

Psychological Mindedness and Spanish Language

Step Variable AR2 df B SEB fl

Stepl
Number of years in U.S. .06* 1,98 -.39* .15 -.25*

Step 2
FFM 99*** 4,95

Openness to Experience 3.98 2.50 .15

Extraversion 3.89 2.67 .15

Neuroticism -8.62*** 2.14 -38***

Step 3
Psychological Mindedness .05** 5,94 15.57** 5.85 .24**

Step 4
Spanish Language .00 6,93 5.63 7.43 .07

Step 5
ACL*ACU .00 7,92 3.32 8.04 .03

Notes: N = 100; *p < .05, **p < . 0 1 , ***p < .001. SOS-10-E = Schwartz Outcome Scale, a
general psychological health measure; FFM = Five Factor Model, Openness to Experience, Extraversion &
Neuroticism composite; Spanish Language=Spanish Language Competence Subtest; ACL*ACU= Interaction term
of U.S. & Latino Acculturation composite scores
 93

Table 13

Summary of Findings

Hypothesis Supported

1. Personality traits, N, O and E, predict SWB level

a. O and E predict higher SOS-10-E, N predicts lower SOS-10-E Partial
b. O and E predict higher PGWBS, N predicts lower PGWBS Partial

2. PM predicts subjective well-being, beyond the effect of the FFM

traits.
a. PM predict higher SOS-10-E Yes
b. PM predict higher PGWBS Yes

3. Level of Acculturation (degree of cultural competence) predicts SWB

beyond FFM and PM.
a. ACU and ACL totals predict higher SOS-10-E No
b. ACU and ACL totals predict higher PGWBS No

4. An interaction effect between the two Acculturation dimensions

(ACL*ACU) predicts SWB.
a. Interaction effect (ACL* ACU) predicts higher SOS-10-E. No
b. Interaction effect (ACL* ACU) predicts higher PGWBS. No

Notes: SOS-10-E = Schwartz Outcome Scale, a general psychological health measure; PGWBS =
Psychological Weil-Being Schedule, a positive and negative affect symptom measure; FFM = Five Factor
Model (Openness to Experience, Extraversion & Neuroticism composite); 0=Openness to Experience;
E=Extraversion; N=Neuroticism; PM = Psychological Mindedness Scale; ACU Competence Composite= U.S.
Acculturation centered composite score of all 3 subscales; ACL Competence Composite= Latino
Acculturation centered composite score of all 3 subscales; ACL*ACU= Interaction term of U.S. & Latino
Acculturation composite scores.
 CHAPTER IV: DISCUSSION

The purpose of this study was to explore the relationship between personality,

psychological mindedness, acculturation and subjective well-being in a clinical Latino

sample. Specifically whether personality traits, level of psychological mindedness, and

extent of acculturation predicted an individual's degree of subjective well-being. This

study was grounded in the Dynamic Equilibrium Model (DEM) of subjective well-being

(Headey & Wearing, 1989), which proposes that individuals have a personal baseline for

positive and negative affect. This baseline is altered by the interaction of the individual's

personality and her/his experiences. Individual's behavior and activities are controlled by

their personality, and their experiences in turn influence their positive and negative affect.

For example, when the individual experiences a stressor, their personality helps return

them to their normal affect baseline.

The data analyzed partially supported the study hypotheses. The findings indicate

the Five Factor Model personality traits of openness to experience and neuroticism are

predictive of subjective well-being in a Latino clinical sample. Also, this study's

findings also support the hypothesis that the stable personality trait of psychological

mindedness is predictive of subjective well-being in a Latino clinical sample.

The hypothesis that acculturation and cultural competence were related to

subjective well-being was not supported. The separate U.S and Latino acculturation

competence composite scores did not predict subjective well-being. An interaction effect

of U.S. and Latino acculturation competence composite scores was also not predictive of

subjective well-being.

94
 95

In addition, analysis of the acculturation subscales, Spanish Language

competence was predictive of subjective well-being when it was assessed with a non-

symptom measure of psychological functioning or well-being (Schwartz Outcome Scale;

SOS-E-10; Blais et al. 2002) and a generic quality of life measure that assessed physical,

cognitive, affective and social-economic domains as symptoms of distress (Psychological

General Well-Being Schedule; PGWBS; Dupuy, 1984).

These findings have implications for clinical work that will be discussed later in

the chapter. The findings will be discussed in more detail, organized by hypothesis,

followed by additional analyses, limitations of the current study and clinical implications.

The chapter ends with suggestions for future research.

Five Factor Model of Personality and Subjective Well-Being

Consistent with past research, the Five Factor Model was predictive of subjective

well-being among a clinical Latino sample when evaluated by a multi-step regression.

This study's findings parallel the work of Ormel & Wohlfarth (1991), Headey & Wearing

(1989), and Schimmack, Diener, & Oishi (2002), which found that extraversion,

neuroticism, and openness to experience traits predicted subjective well-being in non-

Latino samples. When regression beta weights were examined for each of the three traits

in the present study, low neuroticism and high openness to experience were significantly

predictive of subjective well-being when measured as general psychological health. Low

neuroticism was predictive but openness to experience was not significantly predictive of

subjective well-being when it was measured as symptoms of positive and negative affect.

Extraversion was not significantly predictive of subjective well-being as defined by either

measure of subjective well-being.

 96

This finding paralleled a substantial body of research indicating that low

neuroticism is predictive of higher subjective well-being (Ormel & Wohlfarth, 1991). In

fact, this clinical Latino sample's neuroticism level was significantly predictive of their

subjective well-being, with lower rates of neuroticism being related to higher reports of

subjective well-being and lower reports of psychological symptom distress.

This study's findings are consistent with Carrillo et al. (2001). They evaluated

openness to experience in a Latino sample and found a relationship between openness to

experience and subjective well-being among 112 non-clinical individuals from Spain,

when subjective well-being was defined as the presence or absence of depressive

symptoms. Despite the possible cultural differences between the Carrillo et al. (2001)

Spanish participants and this study's diverse Latino participant, the current study found

that openness to experience is significantly predictive of subjective well-being when

defined as general psychological health and well-being. Openness to experience was

related to but did not predict subjective well-being when the definition expanded to

include both symptoms of positive and negative affect.

Using the DEM to explain these findings, the more open to new experiences that

an individual is, the more opportunities for both positive and negative experiences they

might encounter. Also, the more open they are to accepting and seeking out support, the

more likely they are to be able to draw on the necessary resources to return to their

affective equilibrium. Additionally, the less neurotic the individual is, the less s/he may

be inclined to seek out situations that might be emotionally distressing. Such people have

more positive coping mechanisms and are more resilient in the face of negative

experiences, which in turn enables them to return to their emotional baseline faster.
 97

Surprisingly, despite robust findings in other research that extraversion predicts

subjective well-being among non-Latino samples (Costa & McCrae, 1991; DeNeve &

Cooper, 1998), extraversion in this sample did not significantly predict subjective well-

being. While extraversion was positively related to both subjective well-being measures,

when entered into a regression with neuroticism, openness to experience, psychological

mindedness and acculturation, it was not predictive of either measure. A possible reason

for this outcome could be that the other independent variables entered in the regression

had a stronger effect on subjective well-being than extraversion. Also, the mean

extraversion for this sample was lower as compared to the mean of the Latino non-

clinical normative sample. This indicates that the clinical sample of this study was

generally less extraverted than the non-clinical and higher educated sample used to norm

the BFI's Spanish translation. Subjective well-being might only be predicted by higher

extraversion levels.

This sample's extraversion level was lower than previously normed samples.

Being more extraverted might lead to exposure to more experiences that could be both

positive and negative. The DEM hypothesizes that higher extraversion would assist the

individual in returning to their level of equilibrium as the individual would be more

motivated to increase their access to social support. Being less extraverted might mean

that individuals expose themselves to less social stressors, as they might limit their social

interactions. By limiting their interactions, they might seek out and receive less social

support. It is not likely that the participants in this sample limited their social stressors,

but in fact were socially isolated and had limited social supports. A large majority of the

participants in this sample reported social stressors as a reason for seeking psychotherapy
 98

when they were recruited. While recording the responses of the participants, any

elaborations of their responses were also noted. For example, approximately 25% of

individuals clarified that they were sociable although isolated, and tended to discuss their

private concerns with only close friends or family. Many indicated that they feared

becoming the source of rumors in their neighborhoods and housing projects if they

discussed their problems with neighbors or acquaintances.

Psychological Mindedness and Subjective Well-Being

The level of psychological mindedness was predictive of subjective well-being in

a clinical Latino sample. In other words, as the psychological mindedness level of the

participants increased, their subjective well-being level increased as well. These findings

extend the work of Trudeau and Reich (1995), one of the few studies of subjective well-

being and psychological mindedness. In their study of 89 undergraduate students'

emotional well-being, Trudeau and Reich (1995) found that higher psychological

mindedness was predictive of the students' mental well-being level. This indicates that

the more self aware and willing to be introspective the individual is, the fewer symptoms

of distress they report.

Studies have not assessed Latino psychological mindedness levels in either

immigrant or clinical samples. The current study was one of the first to assess the

psychological mindedness level of a clinical Latino population. The psychological

mindedness levels of this study's participants were similar to the psychological

mindedness scores of 212 clinical participants that were predominately non-Hispanic

White, African American and high school educated (Conte, 1996). The participant's PM

Scale scores in the Conte (1996) study were 130.69 ± 14.1, while this sample's PM scale
score was 131.96 ± 15.8. The psychological mindedness score of the Latinos in this

sample was slightly lower on average than that of previous research conducted on

medical students, and U.S. college students of non-Hispanic White, Black, Asian-

American and Hispanic descent (Conte et al. 1995; Beitel, in press). This indicates that

the participant's psychological mindedness level in this study was lower than that of non-

clinical college educated populations.

The current study contradicted previous psychological mindedness studies that

had found psychological mindedness to not be related to education in homogenous

populations (McCullum & Piper, 1997; Conte et al. 1990). This study's psychological

mindedness score was significantly related to education, suggesting that a relationship is

likely between education and psychological mindedness level. This study supported

Conte et al. (1995) who found that medical students psychological mindedness level was

higher than that of a high school educated clinical outpatient sample. Therefore, it

appears that psychological mindedness is a trait or disposition that can be increased

through education and therapeutic training.

Another possible explanation for variations in psychological mindedness is due to

cultural differences. Kleinman (1987) reported that in non-Western societies somatic

complaints that are part of depression and anxiety disorders play a more central role in

the experience and expression of disorders than they do for Western societies. Some

researchers have hypothesized that individuals low in psychological mindedness tend to

manifest their psychological problems in somatization disorders (Fenchel, 2005;

Moodley, 2006). Kleinman (1977) defined somatization as the "expression of personal

and social distress in an idiom of bodily complaints with medical help-seeking."

 100

Kleinman's theory might help explain the lower level of psychological mindedness in this

clinical Latino sample. The Latinos in this sample might not simply be "uninsightful"

per Western standards, but aware of distress and expressing it in a normative and

culturally acceptable manner (Karasz, Sacajiu, & Garcia, 2003). In the course of

responding to the questionnaire, participants elaborated narratively by sharing personal

opinions or explanations to their responses. One participant stated, "When my depressed

husband tells me he doesn't feel well, I feel a heat or cold begin at my feet and rise to my

head. Then I feel sick. I am so worried about him, it makes me sick." Although there

were extensive somatic complaints within this sample, this comment also reflects an

awareness of emotional distress.

Acculturation and Subjective Weil-Being

Latino competence and acculturation were related to higher levels of subjective

well-being. The Latino competence composite, specifically being more competent in

Spanish language and Latino culture, were related to higher levels of well-being for both

measures of subjective well-being. None of the U.S. acculturation competences were

related to subjective well-being. These findings contradict the works of Perez (1998) and

Cuellar and Roberts (1997) who did not find a relationship between acculturation level

and psychological distress.

It was hypothesized that higher acculturation competence would predict higher

subjective well-being among a Latino clinical sample, as individuals would be able to

navigate between both Latino and U.S. cultures more effectively. However, our

hypothesis that acculturation would predict subjective well-being after accounting for the

influence of personality traits was not supported. Previous research has only evaluated
 101

the relationship between acculturation and subjective well-being and has not evaluated

whether acculturation predicts subjective well-being.

The hypothesis that there would be an interaction effect between the U.S.

acculturation competence and Latino competence scales and subjective well-being was

not supported. Combining the two acculturation competence composite scores into one

biculturalism score did not predict subjective well-being. In other words, the cultural

competence level did not predict the level of distress or satisfaction with their

psychological health. These findings do not support the work of Rogler, Cortes, and

Malgady (1991), Martinez (1987), and Lang, Munoz, Bernal, and Sorensen (1982), who

'argued that biculturalism or being competent in both cultures was associated with

subjective well-being.

The lack of interaction effect on subjective well-being might be due to limitations

in the sample. For instance, a large majority of the sample (90%) was in the middle

range of acculturation competence (scores of 3-11), while only 10% of the sample scored

in the bicultural range (scores of 12-16). As per Zea et al. (2003), this middle

acculturation competence group requires additional research to fully understand it's

meaning and subsequently its possible effect on subjective well-being.

In the course of responding to the questionnaire, participants at times elaborated

narratively by sharing personal opinions or explanations to their responses. One

commonly reported source of distress was monolingual status. For example, one

Mexican woman stated, "The hardest thing about living in this country is not knowing the

language. When I need help I ask, but most people say, 'Don't speak Spanish.' It is so

frustrating and scary." When answering the U.S. Identity subscale questions many
 102

participants explained that they felt American because they were citizens, because they

lived here now instead of in their native country, or because they had lived in the host

culture for a long period of time, sometimes longer than they had lived in their native

culture. By contrast, others reported that they did not feel American because they were

either illegal residents or because they were not born in the U.S. One Ecuadorian female

participant described her cultural identity by stating, "Sometimes I feel that I am neither

from here nor there. (Ni de aqui, ni de alia)."

This study's correlation findings support previous research that immigrants who

both retained their culture of origin and who could navigate the U.S. culture and language

with equal competence report less distress (Rogler, Cortes, & Malgady, 1991). Although

acculturation was related to subjective well-being, it was not predictive of subjective

well-being after accounting for personality traits. Many previous studies have used

numerous measures of acculturation, including measures that only assess a global

acculturation level to proxy measures such as language used at home, years in the U.S.,

or generational status. This study utilized an acculturation measure that enabled closer

analysis of what specific aspects of acculturation competence influenced subjective well-

being. This relationship was explored through post hoc analyses.

In post hoc analyses, U.S. acculturation competence composites were related to

the participant's age, education, and number of years in the U.S. U.S. acculturation

competence composites were not related to gender or income. Latino acculturation

competence composites were related to participant's length of time in the U.S. It was not

related to gender, age, education or income. This indicates that the older, more educated

participants that had been in the U.S. longer also tended to report being more competent
in U.S. culture. The participants who reported being in the U.S. a shorter time also

reported being more competent regarding Latino culture.

In contrast to hierarchical regression results, a stepwise regression analysis

indicated that only the Spanish language competence subscale significantly predicted

subjective well-being as measured as a general assessment of psychological health (SOS-

10-E) and by report of positive and negative symptoms (PGWBS). In other words, the

more competent the Latino participants reported being in Spanish, the higher their

subjective well-being.

Based on the stepwise regression results, the Spanish language competence

subscale was entered into the original hierarchical regression model in place of the

acculturation composite scores. Spanish language competence predicted subjective well-

being as measured as a general assessment of psychological health (SOS-10-E), but did

not predict subjective well-being when assessed by report of positive and negative

symptoms (PGWBS). These results support Lopez's (1996) findings that being oriented

toward the culture of origin was related to positive subjective well-being.

This suggests that for immigrants, retaining their language of origin can be

empowering and maintaining connections within their immigrant community might be

important for maintaining psychological health. This study's sample is greatly

disenfranchised, with 91% living within the poverty level in NYC, and the mean

education level being less than 9th grade. On the surface, being financially

disenfranchised is a severe stressor that could impact an individual's subjective well-

being. Yet, maintaining a strong tie to their language of origin enables these participants

to feel connected to others who are similar to them and insulate themselves from a hostile
 104

society. Many participants mentioned having social connections within their housing

projects. By maintaining relationships with individuals from their own culture of origin

and language they create a community in which they fit in and belong.

These additional findings might be explained by the Latino Paradox (Franzini,

Ribble, & Keddie, 2007). The Latino Paradox is the phenomenon where immigrants tend

to fare better regarding physical health (Cho et al. 2004; Eio et al. 2004; Rosenwaike et

al. 1987; Savitz et al. 1986) and report a lower prevalence of psychiatric disorders

(Alegria et al. 2007), while later generations of Latinos fare worse. Although this

phenomenon has not been found to predict subjective well-being specifically, the

protective physical effect of retaining aspects of the person's culture of origin has been

documented among different Latino groups (Eakin et al. 2007; Folsom et al. 2007;

Grzywacz et al. 2007; Rosenwaike et al. 1987; Savitz et al. 1986). Specifically, research

and public policy have suggested that maintenance of the Latino family orientation offers

protection for health maintenance (Bagley et al. 1995). Based on the results of this study,

competence in Spanish Language appears to provide "protection" for subjective well-

being.

Additional Analyses of Acculturation

Post hoc analyses revealed that extraversion, openness to experience, and

neuroticism (FFM traits), and psychological mindedness were related to multiple

acculturation competence subscales. It was unclear what the nature of the relationship

was between these personality traits and the process of acculturation. Extraversion and

openness to experience were related to more acculturation competence subscales than

neuroticism. It is feasible that being more open to experiences, more extraverted and
 105

more psychologically minded might help people navigate within a new culture and,

therefore, assist them in becoming more culturally competent. The more open people are

to new cultures, the more willing they are to interact socially with others. Similarly, the

more willing they are to be introspective, the more culturally competent they become and

the less neurotic they report being. Additionally, participants who scored higher in

neuroticism, reported being less competent in Latino acculturation in general and

specifically less competent in Spanish and Latino culture.

Limitations of the Current Study

There were a few limitations in this study. One limitation specific to the study of

well-being is the issue of response style bias. Some research found response style of

participants biased the correlation pattern in measures of affect (Green, Goldman, &

Salovey, 1993). However, two recent studies found response style bias was negligible on

patterns of correlations in participant's self-reported affect (Schimmack, Bockenholt, &

Reisenzein, 2002; Watson, 2000). Negative affect reports showed even less variability

than positive affect reports.

Another difficulty in the study of well-being is in the measurement instruments of

subjective well-being and mood. Subjective well-being is assessed through self-report

measures, not through observed behavioral indicators. Research suggests that the

participant's current mood can influence the recall of past mood and events (Bower,

1969; Diener, Larsen, & Emmons, 1984). Even further, certain personality traits, such as

Neuroticism, have been found to contribute to how the participant perceives the meaning

of events (Schroeder & Costa, 1984 from Headey & Wearing, 1989). Therefore,
 106

measuring the "true" well-being state of a participant remains a limitation for all

subjective well-being researchers.

In addition, some of the instruments used in the present research have not been

translated and standardized for use with culturally-diverse populations (PGWBS and PM

measure). Although all of the measures in the current study demonstrated adequate

reliability, further research could be conducted to establish appropriate psychometric

properties for diverse groups and Spanish monolinguals.

Another limitation was that, due to linguistic barriers, a majority of the

participants requested that the questions be read aloud to them. The answers were then

recorded by this investigator. Subject demand characteristics of social desirability may

have influenced response style. This was unavoidable, as a majority of this sample

expressed difficulty reading and were unable to answer the questionnaire items without

assistance.

Most of the participants were of lower socioeconomic status and were

immigrants. This clinical sample was chosen specifically in order to test the hypothesis

of personality traits, psychological mindedness and acculturations' relationship with

subjective well-being. The uniqueness of this sample makes it inappropriate to

generalize the results to non-clinical Latinos.

A final limitation in this study may have been the conceptualization of

"acculturation." U.S. and Latino acculturation were defined through composite scores on

subscales of Language, Identity and Cultural competence. The way this variable was

defined and measured will make it difficult to directly compare this study's results to

existing acculturation research. However, the way in which acculturation was defined
within this study captures the acculturation process more fully and inclusively. Future

researchers ought to conceptualize acculturation in a similar fashion, instead of limiting

their definition to simplistic measures such as "amount of time in the U.S." or "language

used at home."

Despite these limitations, the current study made several contributions to the

limited research that has been conducted with a Latino clinical sample that is socially,

educationally, and economically disenfranchised. This was the first study to evaluate the

psychological mindedness level of this unique population. Additionally, this study added

to the existing literature examining the relationship between personality traits and

subjective well-being. Importantly, it extended it to a clinical Latino sample. Lastly,

although the AMAS-ZABB is a relatively new acculturation measure, it is very important

given the changing demographics of the U.S. This study expands normative data for the

AMAS-ZABB to include a clinical Latino sample.

Clinical Implications

Neuroticism and openness to experience predicted subjective well-being

demonstrating the strong influence of personality on positive and negative affect.

Personality ought to be assessed by therapists to assist with the conceptualization of the

client's case and to guide therapeutic interventions.

The lower psychological mindedness within this sample suggests that Latinos of

lower education in fact have lower psychological mindedness levels. The relationship of

psychological mindedness to education indicates that psychological mindedness can be

increased through education and therapeutic training. An important implication for

psychotherapy is that the therapist could spend time explaining the benefits of
psychological mindedness and take a more active role in therapy by verbalizing and

helping the patient make connections. The fact that the psychological mindedness levels

were lower should not be taken to mean that Latinos are not insightful or that they lack

the desire to be introspective. In fact, the lower psychological mindedness score might

simply be a result of how Western culture defines psychological mindedness and how it

is measured. The definition of psychological mindedness might need to be expanded to

include cultural variations.

Lower psychological mindedness is related to higher levels of distress in this

population. This indicates that the less the person is aware of their thoughts and feelings

the more distressed s/he are. This implies that this population could particularly benefit

from therapy. Through therapy the individual would gain insight into her/his thoughts

and distress. As their psychological mindedness increases, their distress would diminish.

The acculturation findings suggest that Spanish Language, and to some degree

cultural affiliation, are potentially a source of support and strength for Latinos.

Particularly for those who are of low socio-economic status and who have recently

immigrated to the United States. For example, an immigrant's identification with her/his

language and culture appear to be a unique coping mechanism. The value of language for

this group points to the need for an increased level of cultural and language competence

of clinicians. One way to achieve this would be to increase the number of Latino and

other culturally trained professionals who could offer therapy in Spanish. Spanish for

this population facilitates the creation of a therapeutic connection, as they can

communicate their thoughts and feelings accurately. Further, as U.S. immigration

 109

increases, these findings have public policy implications in which culture ought to be

taken into account when designing treatment programs and outreach.

Suggestions for Future Research

Future research could examine these same hypotheses within other sub-groups of

the Latino population, such as non-clinical, second and third generation Latino-

Americans, and Latino college samples. The generalizability of the current study's

results would be supported and clarified by expanding the diversity of Latino samples.

Further, the influence of other variables related to personality on the acculturation

process and cultural competence should be examined. Post hoc analyses revealed that the

Five Factor Model traits are related to multiple acculturation competence subscales.

With a larger sample, it would be possible to evaluate whether personality traits moderate

or mediate the process of acculturation.

While gathering data, many participants mentioned their spirituality and religion

as a source of strength and support. Examining this construct's relationship to subjective

well-being and acculturation in a Latino clinical sample is another important area of

research to explore. Lastly, the newly translated measures used in this study should to be

used with other Latino samples to verify that the translated Spanish measure behaves

similarly to the English measure. Specifically, comparing the means and standard

deviations with the English measure's norms would allow for examination of the cross-

cultural construct validity of psychological mindedness. Future research can examine if

the definition of psychological mindedness ought to be expanded to include culturally

specific concepts and terms.

 CHAPTER V: SUMMARY

Introduction

According to the United States Bureau of Census (2005), Latinos represent 14.4%

of the total United States population and have become the largest ethnic group in the U.S.

Ethical and conceptual reasons exist to support further research with ethnic minority

groups given diverse cultures have variations that require modifications of psychotherapy

interventions (Moodley, 2006; Nagayama Hall, 2001; Preciado, 1999; Sciarra &

Ponterotto, 1991). However, Latinos continue to be underrepresented in research

(DeNeve & Cooper, 1998; Organista, Munoz, & Gonzalez, 1994). The existing

knowledge gap regarding mental health predictors must be filled as quickly as possible to

better serve this growing segment of the population. Therapists should be aware that

Latinos have specific needs, coping skills, and sources of strength in order to tailor

psychological care (Curtis, 1990; Moodley & Palmer, 2006; Patel, 1998; Preciado, 1999).

For example, knowledge of the individual's acculturation level could be a useful tool in

developing culturally sensitive therapeutic interventions (Ponterotto, 1987). Armed with

culturally specific knowledge, professionals might foster higher rates of retention with

new Latino patients and provide treatment with higher effectiveness rates (Acosta, 1979;

Hess & Street, 1991; Folsom et al. 2007; Levine & Padilla, 1980; Moodley, 2006;

Organista, Munoz, & Gonzalez, 1994; Parron, 1982; Ponce & Atkinson, 1989).

A psychosocial outcome variable studied in mental health research is subjective

well-being (Perczek et al. 2000). Research into subjective well-being (SWB) has

proliferated in recent years, in part as a reaction to the emphasis of psychology on

negative states and experiences (Diener et al. 1999). There is no single definition of

110
 Ill

subjective well-being. Traditionally, SWB involves a cognitive component in which the

individual evaluates a certain situation and assigns a value judgment to it, as well as an

affective component of both positive and negative affect (Feist et al. 1995; Okun, Stock,

& Covey, 1982). For example, if an individual recently lost her/his employment, s/he

will evaluate this as either a positive or negative event and then identify a positive or

negative emotion s/he experiences as a result. Many theorists include constructs such as

experienced emotions, satisfaction with life's circumstances and a general judgment of

life satisfaction as part of SWB (Diener et al. 1999). SWB is a meaningful outcome

variable commonly assessed through the use of self report measures of related constructs,

such as happiness and life satisfaction; personality qualities, such as vulnerability and

resilience factors; or the absence of unpleasant symptoms such as stress, depression and

anxiety (Carrillo et al. 2001; Perczek et al. 2000; Sandvik et al. 1993).

The literature has suggested that multiple variables determine and predict

subjective well-being (Diener et al. 1999; Feist et al. 1995; Okun, Stock, & Covey, 1982).

Both social and psychological constructs have been found to play a role in determining a

person's SWB, such as socioeconomic status (Lang et al. 1982), immigration status

(Rogler, Malgady, & Rodriguez, 1989), self-esteem (Krause, Bennett, & Van Tran,

1989), resiliency (Abraido-Lanza, 1997; Costa & McCrae, 1993; Perczek et al. 2000;

Ryff, 1989), and personality (Costa & McCrae, 1993). Early research has focused on

demographic variables as predictors of SWB (Andrews & Withey, 1976; Campbell,

Converse, & Rodgers, 1976), yet their low predictive value led researchers to shift

attention to uncovering other more salient predictors of SWB, such as personality traits.
 112

The Five Factor Model (FFM), a broad organization of personality traits in terms

of five basic dimensions, predicted subjective well-being in samples that include

Spaniards, Filipinos, Germans and European Americans (Benet-Martinez & John, 1998;

Katigbak et al. 2002; McCrae & Costa, 1991; Schimmack, Diener, & Oishi, 2002).

Specifically, subjective well-being has been predicted by the personality traits of high

Extraversion, high Openness to Experience, and low Neuroticism (Ormel & Wohlfarth,

1991; Headey & Wearing, 1989; Schimmack, Diener, & Oishi, 2002). Schimmack,

Diener, & Oishi, (2002) propose that personality is more strongly related to the affective

than the cognitive component of SWB. In other words, personality traits are related more

to what the individual experiences emotionally, than to how the person evaluates or

judges her/his emotional experience. Although personality factors have been related to

SWB, they do not explain all of the variance. In order to identify the unique contribution

to SWB, beyond general personality style, two specific variables that measure internal

(psychological) and external (social) influences on subjective well-being may be

psychological mindedness and acculturation level.

Psychological mindedness is the "degree of access to one's feelings, willingness

to understand oneself and others, belief in discussing one's problems, interest in meaning

and motivation of behavior and capacity for change (Conte, Ratto, & Karasu, 1996)."

While little research has been conducted that evaluates how psychological mindedness

(PM) relates to a person's SWB as defined by Diener et al. (1999), PM has been

positively linked to, but not redundant with, attachment security (Beitel & Cecero, 2003),

self-consciousness (Trudeau & Reich, 1995), low Neuroticism, high Openness to

Experience (Beitel & Cecero, 2003), and cognitive flexibility (Beitel, Ferrer, & Cecero,
 113

2004), which are arguably related to SWB. Therefore, research is needed that examines

explicitly the proposed links between SWB and PM. Even further, limited research has

been conducted on Latino samples to establish the PM rates and its impact on subjective

well-being.

Research with SWB has mainly focused on non-Hispanic Whites and ignored

Latinos, or tended to include only a small number of Latinos in their samples despite

(DeNeve & Cooper, 1998; Murguia, 2002; Nagayama Hall, 2001; Sue, 1999). There is a

dearth of research literature specific to Latino and Latina samples (Abraido-Lanzo, 1997;

Lazzari, Ford, & Haughey, 1996; Nagayama Hall, 2001; Ryff, 1989). Further, much of

the SWB research that has focused on Latinos has been conducted on samples that are not

representative of the diverse Latino population. For example, the existing SWB research

samples include older Latinos or Latinos from only specific countries of origin such as

Colombian immigrants or Mexican descendents (Janson & Mueller, 1983; Levin et al.

1996; Liang et al. 1988; Markides & Lee, 1990; Meluk, 2002; Tran, 1995; Tran &

Williams, 1994). To allow generalized research findings, researchers need to expand

their samples to include not only older individuals, but young and middle aged Latinos

from diverse Latino countries. It is crucial that findings be replicated, inconsistencies be

clarified, and that issues specific to this population be identified.

The question regarding what variables beyond personality factors influence SWB

remains unresolved. Nagayama Hall (2001) proposes that culture and ethnicity mediate

an individual's physical health and psychopathology. One variable that differentiates

individuals within minority groups is the process of acculturation. While the process of

acculturation has been cited as a source of distress (Funk, 1993; Moritsugu & Sue, 1983;
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Pearlin, 1989; Rogler, Cortes, & Malgady, 1991), it might be easier for individuals whose

values are similar to those of the United States, who are educated, and who speak English

(Rogler, Cortes, & Malgady, 1991). Acculturation research has found mixed results

when evaluating the relationship between acculturation level and subjective well-being

(Lopez, 1996; Harris-Reid, 1999; Rogler, Cortes, & Malgady, 1991). As a result, the

limited research available is unclear regarding the role that acculturation plays in a

person's subjective well-being (Cuellar and Roberts, 1997; Golding and Burnam, 1990;

Kaplan & Marks, 1990, Krause, Bennett, & Van Tran, 1989; Rogler, Cortes, & Malgady,

1991; Salgado de Snyder, 1987). Consequently, no comparison model exists that

evaluates the relationship between acculturation, PM and FFM on subjective well-being.

Even further, it is unknown if any one or a combination of these independent variables

can predict SWB for specific populations, such as Latinos and Latinas.

Purpose and Rationale

The objective of this study was to examine whether personality traits from the

FFM (Neuroticism, Extraversion, and Openness to Experience), Psychological

Mindedness and Acculturation level positively predict the Subjective Well-Being of

Latinos seeking psychotherapy. The Dynamic Equilibrium Model argues that SWB is

influenced by the FFM and some research exists on the predictive power of FFM on

SWB, but most research available has been conducted with non-Hispanic samples. This

study evaluated the generalizability of these findings to a clinical Latino sample. Little

research has looked at psychological mindedness and level of acculturation. Specifically,

how these two variables alone and combined might predict subjective well-being in a
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Latino sample. This study sought to clarify the conflicting information that exists on the

relationship between acculturation level and subjective well-being.

Hypotheses

This study proposed a number of prediction hypotheses. It was proposed that

Subjective Well-Being level would be predicted by the stable personality traits of

Neuroticism, Extraversion and Openness to Experience, such that the lower the

Neuroticism level and the higher the Extraversion and Openness to Experience, the

higher the level of Subjective Well-Being. It was expected that Subjective Well-Being

would be predicted by higher Psychological Mindedness levels beyond the effect of the

stable Five Factor Model traits. Subjective Well-Being would be significantly predicted

by Acculturation beyond the effect of the stable Five Factor Model traits and

Psychological Mindedness. And finally, the overall level of Acculturation for both U.S.

American and culture-of-origin (Latino) dimensions would predict higher levels of

Subjective Well-Being.

Method

Participants

The Latino study participants were recruited from two community mental health

outpatient clinics specializing in providing bilingual psychotherapy within a New York

City public hospital. Of the 110 eligible individuals approached, 100 consented to

participate, 36% («= 36) were recruited from the long-term treatment clinic and 64% (n=

64) from the time limited treatment clinic (1 to 6 sessions). All but two individuals

required the questionnaires be read to them aloud due to illiteracy or because they

preferred that the lengthy measures be read aloud. A total of 6 individuals completed the
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English version of the measures, as compared to 94 individuals who completed the

Spanish version. No major differences were found between the time-limited and the

long-term clinic participants, when t-test, ANOVA, and chi-square analyses were used to

compare demographic, and independent and dependent variables.

The original subject pool was unevenly distributed by gender, with an almost 4 to

1 ratio favoring female subjects. The final sample consisted of 100 participants, 77%

(«=77) female and 23% (n=23) male, ranging in age from 22 to 82 years old, with a

mean age of 46.7 (SD=\3.5).

All but 2% («=2 ) of the Latino participants were born outside of the United

States. Their country of origin ranged from Colombia, Peru, Argentina, Chile,

Venezuela, Spain, Guatemala, Honduras, and with the largest percentage from Ecuador,

Dominican Republic, Puerto Rico, and Mexico. The mean number of years living within

the United States was 18.6, with a standard deviation of 14.3. With regards to education,

68% (n= 68) of participants reported less than 12 years of education, 17% (n= 17) had a

high school diploma or equivalent, and 15% («= 15) reported some education beyond

high school. The majority (48%, n= 48) of participants reported being married, although

25% (n= 25) were single and 27% («= 27) were divorced, separated or widowed. More

than half the sample reported being unemployed (67%, n= 67), while 16% (n= 16)

reported working part-time and 17% (n= 17) reported working full-time. A majority of

the sample reported being in a low income bracket, with 57% (n- 57) earning between $0

to $10,000 per year, 34% («= 34) earning between $10,000 to $20,000 per year, 8% («=

8) earning 20,000 to 30,000 per year, and only 1% (n= 1) earning 40,000 to 50,000 per

year. A total of 91% («= 91) of this sample earned less than $20,000 per year, and fell
 117

within the poverty threshold (U.S. Bureau of Census, 2005). This study's sample is over-

representative of the percentage of Latino and foreign born population living in poverty.

Procedures

The study's Latino participants were recruited at time of intake from outpatient

mental health clinics specialized in providing bilingual psychotherapy within a New York

City hospital. Exclusion criteria included individuals with a history of psychotic or

dementia symptoms. After informed consent was obtained, the participants were given a

packet that included a demographic questionnaire, the Psychological Mindedness Scale

(PM Scale), the Abbreviated Multidimensional Acculturation Scale (AMAS-ZABB), the

Psychological General Weil-Being Schedule (PGWBS), the Schwartz Outcome Scale-10-

E (SOS-10-E), and the Big Five Inventory (BFI). Except for the demographic

questionnaire, all measures were randomly ordered. The participants were given the

options of completing English or Spanish forms.

Instrument Translation Procedure

Measures that were only available in English were translated into Spanish and

back-translated to verify the same construct was captured in the Spanish version (Arnold

& Matus, 2000; Berry, 1986; Brislin, 1970, 1976; Rivera Mindt et. al. 2003). The

methodology used within this study was the Back Translation Method and the Team or

Panel Method, which are described in greater detail by Arnold and Matus (2000).

Instruments

Five Factor Model of Personality: The Big Five Inventory (BFI)-Spanish version

(Benet-Martinez & John, 1998) is a self-report measure of the five traits in the Five

Factor Model that includes 44 characteristics, scored on a 5-point Likert scale ranging
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from "agree strongly" to "disagree strongly." The BFI has substantial convergent

validity with Costa and McCrae's (1992) definitions of the Five-Factor Model.

Benet-Martinez & John (1998) translated the BFI into the Spanish language and

validated the translated measure in three separate studies. The internal consistencies in

the English language scales were high with average alpha being .83, while the average

alpha coefficients for the Spanish translation was .78. Cross language convergence

between the Spanish and English BFI ranging from .65 to .84. Discriminant and

convergent validity were established.

Psychological Mindedness: The Psychological Mindedness Scale (PM)-Spanish

translation (Conte et al. 1990) is a self-report scale that includes 45 items, scored on a 4-

point Likert scale ranging from "strongly agree" to "strongly disagree" (see Appendix A).

This scale was based on Lotterman's (1979) unpublished 65 item scale. The scale was

designed to measure Psychological Mindedness as defined by Conte et al. (1996).

Twenty four of the items load positively with PM, while 21 load negatively and must be

reverse coded. This measure was translated into Spanish for use in this study (see the

Instrument Translation Procedures Section).

Acculturation: The Abbreviated Multidimensional Acculturation Scale (AMAS-ZABB;

Zea et al. 2003) is a bilinear (separate measurements of adaptation within the culture of

origin and within the host culture), and multidimensional scale of Acculturation. This

self-report scale contains 42 items scored on a 4-point Likert scale ranging from

"strongly agree" to "strongly disagree." This scale assesses the dimension of 3 factors

associated with acculturation in both the United States and culture-of-origin, which

include identity, language and cultural competence. The average of these factors captures
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the level of acculturation on the U.S.-American dimension (three factors) and the culture-

of-origin dimension (three factors). Biculturalism can be assessed by multiplying the

U.S.-American dimension average and the culture-of-origin dimension average. Based

on preliminary results, high scores (12-16) indicate biculturalism, while low scores (1-2)

indicate marginalism. The meaning of scores in the middle requires additional research

to better understand their significance. The English and Spanish versions of this scale

were validated on community and college student Latino samples (Zea et al. 2003).

Subjective Well-Being: Two measures of Subjective Well-Being were used to capture

different aspects of the participant's well-being. The first SWB measures was the

Schwartz Outcome Scale-10-E (SOS-10-E), a scale translated by Rivas-Vazquez et al.

(2001) that taps broad domains of psychological health and demonstrates strong

divergent correlations with measures of psychopathology and strong convergent

correlation with measures of Subjective Well-Being. This self-report scale contains 10

items scored on a 6-point Likert scale ranging from "never" to "all the time or almost all

the time." The higher scores indicate higher levels of well-being. Analysis of the

translation of the SOS-10 to SOS-10-E was conducted with 100 foreign born bilingual

volunteers (Rivas-Vazquez et al. 2001). English and Spanish version scale scores

correlated at .86 (p< .001). The test-retest correlation was .86 with an average interval

retestof 7 days.

The second measure of Subjective Well-Being used was the Psychological

General Well-Being Schedule (PGWBS)-Spanish translation (Dupuy, 1984). This

measure captures both negative and positive intrapersonal affective and emotional well-

being as well as distress experienced within the past month (see Appendix B). This is a
generic quality of life measure that assesses physical, cognitive, affective and social

economic domains (Bech, 1995). The PGWBS is a 22 item index, with six subscales,

which include anxiety, depressed mood, positive well-being, self-control, general health,

and vitality. The item response ranges from 0 to 5 points, with lower points reflecting

negative answers and higher points reflecting positive answers. The possible scores

range from 0 to 110, with the elevated scores reflecting greater well-being. This measure

was translated for this study (see Instrument Translation Procedure section).

Demographic Data: A demographic questionnaire (refer to Appendix C & D) developed

for this study ask participants to report their age, gender, country of origin, number of

years living in the United States, marital status, educational attainment, and employment

status.

Results

Measure Descriptives

The means and standard deviations for most scales utilized in this study

performed as expected. The internal consistency reliability for each scale was evaluated

and found within the acceptable range of a= .70 or higher.

Correlations of Demographics with Dependent Variables

A Pearson correlation analysis was conducted between the demographic variables

and the dependent variables (see Table 6). The number of years living in the U.S. was

significantly correlated with the Subjective Well-Being measure PGWBS, but not with

the SOS-10-E. Suggesting that the longer the participant's lived in the U.S. the lower

their reported Subjective Weil-Being. The number of years living in the U.S. was

controlled for in subsequent inferential analysis. The number of months in previous

therapy was significantly negatively correlated with Subjective Well-Being measure

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SOS-10-E, but not correlated with PGWBS. One participant outlier endorsed 84 months

in previous therapy and was removed from the analysis. Subsequent inferential analyses

for SOS-10-E were performed with 99 participants.

Correlations of Independent and Dependent Variables

The Pearson correlation analyses were conducted with all 100 participants (see

Table 6). The dependent measures were significantly correlated with each other,

suggesting that the SWB measures tapped related constructs. The independent

personality variables were also significantly correlated with the dependent variables

(SOS-10-E and PGWBS); Extraversion, Openness to Experience, and negatively

correlated to Neuroticism. The higher levels of Extraversion and Openness to Experience

were associated with higher Subjective Well-Being scores. PM was correlated

significantly to SOS-10-E and PGWBS. Psychological Mindedness was associated with

higher Subjective Weil-Being. The two stable personality independent variables (FFM

and PM) were significantly correlated with each other, PM was positively correlated to

Extraversion, to Openness to Experience, and negatively correlated to Neuroticism.

Higher levels of Psychological Mindedness were associated with higher Extraversion and

Openness to Experience and lower Neuroticism scores.

The U.S. Acculturation competence composite and subscale scores were not

significantly correlated with SOS-10-E. Only the Latino Acculturation subscales and

composite scores were related to SWB. The Latino Acculturation subscales of Language

competence, and Cultural competence, and the Latino Acculturation composite total were

significantly correlated to SOS-10-E. Therefore, higher scores on Latino Acculturation

competence were associated with higher Subjective Weil-Being scores.

 The Latino Acculturation subscales of Language competence, and Cultural

competence were correlated significantly with the PGWBS. Unlike the Subjective Well-

Being measure of SOS-10-E, PGWBS was not correlated to the Latino Acculturation

cumulative scale or the U.S. Acculturation subscale and composite scores. Only Latino

Acculturation competence subscales were related to SWB.

Inferential Statistics

The principal analysis used in this study to test all hypotheses was a hierarchical

multiple regression. In order to control for the correlation effects of the number of years

in the U.S., the demographic variable was entered as a first step in the regression. The

three personality traits (FFM) were entered as the second step in the hierarchical

regression, the PM variable was entered as a third step, both the U.S. and Latino

Acculturation centered composite totals were entered as a fourth step, the Acculturation

interaction term was entered as a fifth step with the SOS-10-E entered as the dependent

variable. Based on the mixed findings in the Acculturation literature, the Acculturation

interaction variable was entered separately from the Acculturation composite variables.

A separate hierarchical regression analysis was conducted for PGWBS using procedures

detailed above. Beta weights were evaluated in order to compare the relative influence of

each variable to the overall variance.

The first hypothesis predicted that low Neuroticism, high Extraversion, and high

Openness to Experience would predict SWB. The first step controlling for years in the

U.S. was not significant, R*= .04, F (1, 97) = 3.80; p = .054. The second step including

the three personality traits was significantly predictive of SWB, R2= .38, F (4, 94) =

14.40; p < . 001 and (AR2 =.34). The beta weights were only significant for Neuroticism
 123

(P = -.50, p < .001) and Openness to Experience (P = .24, p = .012). The higher scores of

Openness to Experience and lower Neuroticism scores predicted higher SOS-10-E scores.

The personality traits of Neuroticism and Openness to Experience account for 34% of the

variance. This hypothesis was partially supported.

The second regression for PGWBS was conducted using procedures detailed

above. The first step controlling for years in the U.S. was significantly predictive of

SWB, R2= .06, F(l, 98) = 6.42;/? <.013. The second step of the regression including the

three personality traits, was significantly predictive of SWB, R2= .35, F (4, 95) = 12.74; p

< .001 and (AR2 =.29). The beta weights were only significant for Years in U.S. (p = -

.25, p = .013) and Neuroticism (P = -.38,/? < .001). The BFI Neuroticism scores account

for most of the variance. This hypothesis was partially supported.

The second hypothesis was that Subjective Weil-Being scores would be predicted

by Stable Psychological Mindedness, beyond the effect of the FFM traits. Hierarchical

regression analysis was conducted for SOS-10-E using procedures detailed above. PM

was significant, R2= .43, F (5, 93) = 13.97; p = .006. The R-squared indicates that

Psychological Mindedness is predictive of Subjective Well-Being beyond the FFM (AR2

=.05). The relative predictive power of PM was inspected by evaluating the standardized

beta weight and was significant (P = .25, p = .006). PM accounted for 5% of the

variance. This hypothesis was supported.

The second hierarchical regression analysis was conducted for PGWBS using

procedures detailed above. This third step in the regression was significant, R2= .40, F

(5,94)= 12.26;/?= .009. Based on the R-squared, Psychological Mindedness is

predictive of Subjective Well-Being beyond the FFM again to a small degree (AR2 =.05).
The relative predictive power of PM was inspected by evaluating standardized the beta

weight and was significant (fJ = .24, p = .009). PM accounted for 5% of the variance.

This hypothesis was supported.

The third Hypothesis was that Subjective Well-Being scores would be predicted

by higher scores on both U.S. and Latino Acculturation competence dimensions at the

same time, while controlling for the effects of FFM and PM. The three subscales

(Language, Identity, Culture) from the U.S. Acculturation competence dimensions were

added together, the mean was then centered to create the ACU competence composite

score (U.S.-American Acculturation competence dimension). The same procedure was

followed to create the ACL competence composite score (Latino competence dimension).

This hypothesis was evaluated by conducting a hierarchical regression analysis of

SOS-10-E using procedures detailed above. This fourth step in the regression was not

significant, i?2= .44, F (7, 91) = 10.22; p = .41, and was reflected by the small change in

R-squared (AR2 =.01). The standardized beta weights for the Acculturation composite

scores were not significant. This hypothesis was not supported.

This second hierarchical regression analysis of PGWBS was conducted using

procedures detailed above. This fourth step in the regression was not significant, R2= .40,

F (7, 92) = 8.65; p = .84, and is reflected by the small change in R-squared (AR2 =.002).

The beta weights were not significant for the ACU and ACL competence composite

scores. This hypothesis was not supported.

The fourth hypothesis was that an interaction effect between the two

Acculturation dimensions, U.S.-American (ACU subscale totals) and culture-of-origin

competence (ACL subscale totals) would predict Subjective Well-Being. An interaction

variable was created by multiplying the centered ACL and ACU competence composite

scores (ACL*ACU) from the AMAS-ZABB.

This hypothesis was evaluated by conducting a hierarchical regression analysis of

SOS-10-E using procedures detailed above. This fifth step in the regression was not

significant, R2= .44, F (8, 90) = 9.02; p = .38, and was reflected by the small change in

R-squared (AR2 =.005). The relative predictive power of the ACL* ACU was inspected

by evaluating standardized beta weights and was not significant. This hypothesis was not

supported.

The hierarchical regression analysis for PGWBS as dependent variables using

procedures detailed above was not significant for PGWBS, R2= .40, F (8, 91) = 7.54;;? =

.62, and was reflected by the small change in R2 from step 4 to step 5 (AR2 =.002). The

standardized beta weight for the ACL* ACU interaction term was not significant. This

hypothesis was not supported.

Post Hoc Analyses

Previous Acculturation research has found mixed results regarding its predictive

power of Subjective Weil-Being. The lack of clarity might be due to researchers use of

different measures of Acculturation. This study used an Acculturation measure that

allowed for exploration of independent predictors to distinguish which subscales were

most influential in predicting Subjective Weil-Being (Language, Identity or Cultural

competence). Based on trends in the data and unexpected findings with this culturally

unique clinical sample, additional analyses were conducted. First, correlations between

PM and demographic variables were conducted. Pearson product-moment correlations

for the Personality and Acculturation subscales were conducted to explore their
interrelations. Finally, the Acculturation subscales were analyzed independently for

correlations to demographics, and stepwise and hierarchical regressions were conducted.

Contrary to prior research (McCullum & Piper, 1997; Conte et al. 1990; Conte &

Ratto, 1997), PM was significantly correlated to the education of these participants.

Higher scores of Psychological Mindedness were associated with higher levels of

education. The independent personality variables were also significantly correlated with

many of the Acculturation competence subscales and composite scores. The PM score

was significantly positively correlated to U.S. Culture, Latino Culture, and negatively

correlated to Latino Identity. Therefore, higher PM scores were associated with higher

competence in U.S. Culture and Latino Culture, but lower levels of Latino Identity.

Extraversion was significantly positively correlated to English Language, U.S.

Culture, and Latino Culture, and negatively correlated to Latino Identity. Higher scores

of Extraversion were related to higher competence in English Language and Culture, as

well as Latino Culture and Identity. Extraversion was significantly correlated to the U.S.

Acculturation competence composite score, but not to the Latino competence composite

score. Higher Extraversion scores were associated with higher U.S. Acculturation

competence.

Openness to Experience was significantly correlated to English Language, U.S.

Culture, Latino Culture, and negatively correlated to Latino Identity. Higher Openness to

Experience scores were associated with higher competence in English Language, Culture,

and Latino Culture, but lower Latino Identity. Openness to Experience was significantly

correlated to the ACU (U.S.) competence composite score but not to the ACL (Latino)
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competence composite score. Higher Openness to Experience scores were associated

with higher U.S. Acculturation competence.

Neuroticism was negatively significantly correlated to the Spanish Language,

Latino Culture, and the Latino Acculturation competence composite score. Higher

Neuroticism scores were associated with lower competence in Spanish Language and

Culture, and Latino Acculturation competence in general.

The mixed predictive results of the Acculturation scores led to further statistical

exploration of the Acculturation subscales. Correlation analyses were conducted between

Acculturation scores and demographic variables. The number of years in the U.S. was

related to both ACL competence composite and ACU competence composite. Therefore,

higher scores on Latino acculturation competence were associated with less years in the

United States, and higher scores on the U.S. acculturation competence were associated

with being in the U.S. a longer amount of time. Both age and level of education were

related to the ACU competence composite. Participants who were older and more

educated reported higher scores on the U.S. competence composite. Based on six

independent t-tests, significance was not detected by gender. None of the U.S.

Acculturation and Latino Acculturation subscale scores were significantly correlated with

the income.

Separate stepwise regression analyses were conducted for the dependent variables

SOS-10-E and PGWBS. The demographic variable and all six Acculturation competence

subscale scores were entered into the stepwise regression as one step in order to ascertain

which subscales contributed most to the prediction of SOS-10-E and PGWBS.

Contrasting the results from the hierarchical regression for SOS-10-E, the Spanish
Language subscale was significant, R2= .15, F{\, 97) = 16.91;/? < .001 (P = .39,p <

.001). Again, dissimilar to the results from the hierarchical regression for PGWBS the

demographic variable Years in the U.S. was significant, R2= .06, F (1, 98) = 6.42; p <

.013 (p = -.25, p < .05) and the Spanish Language subscale was significant, R2= .04, F(2,

97) = 5.29; p < .007 (p = .19,p < .05). No other Acculturation subscales were

significant.

Based on these step-wise regression results, the original hierarchical regression

model was used to test whether Spanish Language, not the Acculturation composite

scores, can predict SWB beyond the effects of personality. The Spanish Language

subscale score was entered as the fourth step in two separate hierarchical regressions for

each dependent variable. The first three steps of the regression remained the same as

reported previously when regressed upon SOS-10-E, the fourth step in the regression was

significant, R2~ .68, F (6, 92) = 13.37;/?= .014. Based on the R-squared, Spanish

Language is predictive of Subjective Well-Being beyond the FFM and PM, and accounts

for 4% of the variance (AR2 =.04).

Spanish Language was not significant when PGWBS was used as the dependent

measure of SWB, R2= .40, F (6, 93) = 10.27; p= .45, (AR2 =.004). A possible reason

why Spanish Language was predictive of Subjective Well-Being for one measure of

SWB and not the other is that each measure tapped different well-being domains. The

SOS-10-E tapped broad domains of psychological health, while the PGWBS captured

both negative and positive intra-personal affective and emotional well-being, as well as

distress experienced within the past month.

 Discussion

The purpose of this study was to explore the relationship between personality,

psychological mindedness, acculturation and subjective well-being in a clinical Latino

sample. Specifically whether personality traits, level of psychological mindedness, and

extent of acculturation predicted an individual's degree of subjective well-being.

The data analyzed partially supported the study hypotheses. The findings indicate

the Five Factor Model personality traits of openness to experience and neuroticism are

predictive of subjective well-being in a Latino clinical sample. Also, this study's

findings also support the hypothesis that the stable personality trait of psychological

mindedness is predictive of subjective well-being in a Latino clinical sample.

The hypothesis that acculturation and cultural competence were related to

subjective well-being was not supported. The separate U.S and Latino acculturation

competence composite scores did not predict subjective well-being. An interaction effect

of U.S. and Latino acculturation competence composite scores was also not predictive of

subjective well-being.

In addition, analyses of the acculturation subscales, Spanish Language

competence was predictive of subjective well-being when it was assessed with a non-

symptom measure of psychological functioning or well-being (Schwartz Outcome Scale;

SOS-E-10; Blais et al. 2002) and a generic quality of life measure that assessed physical,

cognitive, affective and social-economic domains as symptoms of distress (Psychological

General Weil-Being Schedule; PGWBS; Dupuy, 1984).

These findings have implications for clinical work that will be discussed later in

the chapter. The findings will be discussed in more detail, organized by hypothesis,
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followed by additional analyses, limitations of the current study and clinical implications.

The chapter ends with suggestions for future research.

Five Factor Model of Personality and Subjective Well-Being

Consistent with past research, the Five Factor Model was predictive of subjective

well-being among a clinical Latino sample when evaluated by a multi-step regression.

This study's findings parallel the work of Ormel & Wohlfarth (1991), Headey & Wearing

(1989), and Schimmack, Diener, & Oishi (2002), which found that extraversion,

neuroticism, and openness to experience traits predicted subjective well-being in non-

Latino samples. When regression beta weights were examined for each of the three traits

in the present study, low neuroticism and high openness to experience were significantly

predictive of subjective well-being when measured as general psychological health. Low

neuroticism was predictive but openness to experience was not significantly predictive of

subjective well-being when it was measured as symptoms of positive and negative affect.

Extraversion was not significantly predictive of subjective well-being as defined by either

measure of subjective well-being.

This finding paralleled a substantial body of research indicating that low

neuroticism is predictive of higher subjective well-being (Ormel & Wohlfarth, 1991). In

fact, this clinical Latino sample's neuroticism level was significantly predictive of their

subjective well-being, with lower rates of neuroticism being related to higher reports of

subjective well-being and lower reports of psychological symptom distress.

This study's findings are consistent with Carrillo et al. (2001). Despite the

possible cultural differences between the Carrillo et al. (2001) Spanish participants and

this study's diverse Latino participant, the current study found that openness to
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experience is significantly predictive of subjective well-being when defined as general

psychological health and well-being. Openness to experience was related to but did not

predict subjective well-being when the definition expanded to include both symptoms of

positive and negative affect.

Using the DEM to explain these findings, the more open to new experiences that

an individual is, the more opportunities for both positive and negative experiences they

might encounter. Also, the more open they are to accepting and seeking out support, the

more likely they are to be able to draw on the necessary resources to return to their

affective equilibrium. Additionally, the less neurotic the individual is, the less s/he may

be inclined to seek out situations that might be emotionally distressing. Such people have

more positive coping mechanisms and are more resilient in the face of negative

experiences, which in turn enables them to return to their emotional baseline faster.

Surprisingly, despite robust findings in other research that extraversion predicts

subjective well-being among non-Latino samples (Costa & McCrae, 1991; DeNeve &

Cooper, 1998), extraversion in this sample did not significantly predict subjective well-

being. While extraversion was positively related to both subjective well-being measures,

when entered into a regression with neuroticism, openness to experience, psychological

mindedness and acculturation, it was not predictive of either measure. A possible reason

for this outcome could be that the other independent variables entered in the regression

had a stronger effect on subjective well-being than extraversion.

Psychological Mindedness and Subjective Well-Being

The level of psychological mindedness was predictive of subjective well-being in

a clinical Latino sample. In other words, as the psychological mindedness level of the
 132

participants increased, their subjective well-being level increased as well. These

findings extend the work of Trudeau and Reich (1995), one of the few studies of well-

being and psychological mindedness. This indicates that the more self aware and willing

to be introspective the individual is, the fewer symptoms of distress they report.

Studies have not assessed Latino psychological mindedness levels in either

immigrant or clinical samples. The current study was one of the first to assess the

psychological mindedness level of a clinical Latino population. The psychological

mindedness levels of this study's participants were similar to the psychological

mindedness scores of 212 clinical participants that were predominately non-Hispanic

White, African American and high school educated (Conte, 1996). The psychological

mindedness score of the Latinos in this sample was slightly lower on average than that of

previous research conducted on medical students, and U.S. college students of non-

Hispanic White, Black, Asian-American and Hispanic descent (Conte et al. 1995; Beitel,

in press). This indicates that the participant's psychological mindedness level in this

study was lower than that of non-clinical college educated populations.

The current study contradicted previous psychological mindedness studies that

had found psychological mindedness to not be related to education in homogenous

populations (McCullum & Piper, 1997; Conte et al. 1990). This study's psychological

mindedness score was significantly related to education, suggesting that a relationship is

likely between education and psychological mindedness level. This study supported

Conte et al. (1995) who found that medical students psychological mindedness level was

higher than that of a high school educated clinical outpatient sample. Therefore, it
 133

appears that psychological mindedness is a trait or disposition that can be increased

through education and therapeutic training.

Another possible explanation for variations in psychological mindedness is due to

cultural differences. Kleinman (1987) reported that in non-Western societies somatic

complaints that are part of depression and anxiety disorders play a more central role in

the experience and expression of disorders than they do for Western societies. Some

researchers have hypothesized that individuals low in psychological mindedness tend to

manifest their psychological problems in somatization disorders (Fenchel, 2005;

Moodley, 2006). Kleinman (1977) defined somatization as the "expression of personal

and social distress in an idiom of bodily complaints with medical help-seeking."

Kleinman's theory might help explain the lower level of psychological mindedness in this

clinical Latino sample. The Latinos in this sample might not simply be "uninsightful"

per Western standards, but aware of distress and expressing it in a normative and

culturally acceptable manner (Karasz, Sacajiu, & Garcia, 2003). In the course of

responding to the questionnaire, participants elaborated narratively by sharing personal

opinions or explanations to their responses. One participant stated, "When my depressed

husband tells me he doesn't feel well, I feel a heat or cold begin at my feet and rise to my

head. Then I feel sick. I am so worried about him, it makes me sick." Although there

were extensive somatic complaints within this sample, this comment also reflects an

awareness of emotional distress.

Acculturation and Subjective Well-Being

Latino competence and acculturation were related to higher levels of subjective

well-being. The Latino competence composite, specifically being more competent in

Spanish language and Latino culture, were related to higher levels of well-being for both

measures of subjective well-being. None of the U.S. acculturation competences were

related to subjective well-being. These findings contradict the works of Perez (1998)

and Cuellar and Roberts (1997) who did not find a relationship between acculturation

level and psychological distress.

It was hypothesized that higher acculturation competence would predict higher

subjective well-being among a Latino clinical sample, as individuals would be able to

navigate between both Latino and U.S. cultures more effectively. However, our

hypothesis that acculturation would predict subjective well-being after accounting for the

influence of personality traits was not supported. Previous research has only evaluated

the relationship between acculturation and subjective well-being and has not evaluated

whether acculturation predicts subjective well-being.

The hypothesis that there would be an interaction effect between the U.S.

acculturation competence and Latino competence scales and subjective well-being was

not supported. Combining the two acculturation competence composite scores into one

biculturalism score did not predict subjective well-being. In other words, the cultural

competence level did not predict the level of distress or satisfaction with their

psychological health. These findings do not support the work of Rogler, Cortes, and

Malgady (1991), Martinez (1987), and Lang, Munoz, Bernal, and Sorensen (1982), who

argued that biculturalism or being competent in both cultures was associated with

subjective well-being.

The lack of interaction effect on subjective well-being might be due to limitations

in the sample. For instance, a large majority of the sample (90%) was in the middle
 135

range of acculturation competence (scores of 3-11), while only 10% of the sample scored

in the bicultural range (scores of 12-16). As per Zea et al. (2003), this middle

acculturation competence group requires additional research to fully understand it's

meaning and subsequently its possible effect on subjective well-being.

This study's correlation findings support previous research that immigrants who

both retained their culture of origin and who could navigate the U.S. culture and language

with equal competence report less distress (Rogler, Cortes, & Malgady, 1991). Although

acculturation was related to subjective well-being, it was not predictive of subjective

well-being after accounting for personality traits. Many previous studies have used

numerous measures of acculturation, including measures that only assess a global

acculturation level to proxy measures such as language used at home, years in the U.S.,

or generational status. This study utilized an acculturation measure that enabled closer

analysis of what specific aspects of acculturation competence influenced subjective well-

being. This relationship was explored through post hoc analyses.

In post hoc analyses, U.S. acculturation competence composites were related to

the participant's age, education, and number of years in the U.S. U.S. acculturation

competence composites were not related to gender or income. Latino acculturation

competence composites were related to participant's length of time in the U.S. It was not

related to gender, age, education or income. This indicates that the older, more educated

participants that had been in the U.S. longer also tended to report being more competent

in U.S. culture. The participants who reported being in the U.S. a shorter time also

reported being more competent regarding Latino culture.

 In contrast to hierarchical regression results, a stepwise regression analysis

indicated that only the Spanish language competence subscale significantly predicted

subjective well-being as measured as a general assessment of psychological health (SOS-

10-E) and by report of positive and negative symptoms (PGWBS). In other words, the

more competent the Latino participants reported being in Spanish, the higher their

subjective well-being.

Based on the stepwise regression results, the Spanish language competence

subscale was entered into the original hierarchical regression model in place of the

acculturation composite scores. Spanish language competence predicted subjective well-

being as measured as a general assessment of psychological health (SOS-10-E), but did

not predict subjective well-being when assessed by report of positive and negative

symptoms (PGWBS). These results support Lopez's (1996) findings that being oriented

toward the culture of origin was related to positive subjective well-being.

This suggests that for immigrants, retaining their language of origin can be

empowering and maintaining connections within their immigrant community might be

important for maintaining psychological health. This study's sample is greatly

disenfranchised, with 91% living within the poverty level in NYC, and the mean

education level being less than 9th grade. On the surface, being financially

disenfranchised is a severe stressor that could impact an individual's subjective well-

being. Maintaining their language of origin enables these participants to feel connected

to others who are similar to them and insulate themselves from a hostile society.

These additional findings might be explained by the Latino Paradox (Franzini,

Ribble, & Keddie, 2007), a phenomenon where immigrants tend to fare better regarding
physical health (Cho et al. 2004; Eio et al. 2004; Rosenwaike et al. 1987; Savitz et al.

1986) and report a lower prevalence of psychiatric disorders (Alegria et al. 2007), while

later generations of Latinos fare worse. Although this phenomenon has not been found to

predict subjective well-being specifically, the protective physical effect of retaining

aspects of the person's culture of origin has been documented among different Latino

groups (Eakin et al. 2007; Folsom et al. 2007; Grzywacz et al. 2007; Rosenwaike et al.

1987; Savitz et al. 1986). Specifically, research and public policy have suggested that

maintenance of the Latino family orientation offers protection for health maintenance

(Bagley et al. 1995). Based on the results of this study, competence in Spanish Language

appears to provide "protection" for subjective well-being.

Additional Analyses of Acculturation

Post hoc analyses revealed that extraversion, openness to experience, and

neuroticism (FFM traits), and psychological mindedness were related to multiple

acculturation competence subscales. It was unclear what the nature of the relationship

was between these personality traits and the process of acculturation. Extraversion and

openness to experience were related to more acculturation competence subscales than

neuroticism. It is feasible that being more open to experiences, more extraverted and

more psychologically minded might help people navigate within a new culture and,

therefore, assist them in becoming more culturally competent. The more open people are

to new cultures, the more willing they are to interact socially with others. Similarly, the

more willing they are to be introspective, the more culturally competent they become and

the less neurotic they report being.

 Limitations of the Current Study

There were a few limitations in this study. One difficulty in the study of well-

being is response style and in the use of self-report measures. Therefore, measuring the

"true" well-being state of a participant remains a limitation for all subjective well-being

researchers. Another limitation is that some of the instruments used in the present

research have not been translated and standardized for use with culturally-diverse

populations (PGWBS and PM measure). Most of the participants were of lower

socioeconomic status and were immigrants. The uniqueness of this sample makes it

inappropriate to generalize the results to non-clinical Latinos. A final limitation in this

study was the way acculturation was defined and measured, as it will make it difficult to

directly compare this study's results to existing acculturation research.

Clinical Implications and Suggestions for Future Research

These results demonstrated the strong influence of personality on positive and

negative affect. Personality ought to be assessed by therapists to assist with the

conceptualization of the client's case and to guide therapeutic interventions. The lower

psychological mindedness within this sample suggests that Latinos of lower education in

fact have lower psychological mindedness levels. The relationship of psychological

mindedness to education indicates that psychological mindedness can be increased

through education and therapeutic training. Also, lower psychological mindedness is

related to higher levels of distress in this population. This indicates that the less the

person is aware of their thoughts and feelings the more distressed s/he are.

The acculturation findings suggest that Spanish language, and to some degree

cultural affiliation, are potentially a source of support and strength for Latinos.
Particularly for those who are of low socio-economic status and who have recently

immigrated to the United States. The value of language for this group points to the need

for an increased level of cultural and language competence of clinicians. One way to

achieve this would be to increase the number of Latino and other culturally trained

professionals who could offer therapy in Spanish. Spanish for this population facilitates

the creation of a therapeutic connection, as they can communicate their thoughts and

feelings accurately. Further, as U.S. immigration increases, these findings have public

policy implications in which culture ought to be taken into account when designing

treatment programs and outreach.

Future research could examine these same hypotheses within other sub-groups of

the Latino population, such as non-clinical, second and third generation Latino-

Americans in order to confirm the generalizability of the current study's results. Using a

larger sample would make it possible to evaluate whether personality traits moderate or

mediate the process of acculturation. Lastly, the newly translated measures used in this

study should to be used with other Latino samples to verify that the translated Spanish

measure behaves similarly to the English measure.

The current study made several contributions to the limited research that has been

conducted with a Latino clinical sample that is socially, educationally, and economically

disenfranchised. This was the first study to evaluate the psychological mindedness level

of this unique population. Additionally, this study added to the existing literature

examining the relationship between personality traits and subjective well-being as well as

extended it to a clinical Latino sample. Lastly, multiple measures were translated into

Spanish that can be utilized in both clinical and research settings.

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Wiggins, J.W. & Pincus, A. (1989). Conceptions of personality disorders and dimensions
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Worrell, F. C , & Cross, W. E. Jr. (2004). The reliability and validity of Big Five
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 160

APPENDIX A

PSYCHOLOGICAL MINDEDNESS SCALE-SPANISH TRANSLATION

 161

Escala de Predisposition Psicologica

Psychological Mindedness Scale (PM Scale-Spanish Translation)

Hay una lista de cuarenta y cinco declaraciones abajo. Cada declaration es seguida por
cuatro frases.
Fuertemente de acuerdo
De acuerdo en su mayor parte (de acuerdo la mayor parte del tiempo)
En desacuerdo en su mayor parte (en desacuerdo la mayor parte del tiempo)
Fuertemente en desacuerdo

Por favor ponga una flecha a continuation de la frase que mejor describe como se siente.
Muy de Mas o menos Mas o menos en Muy en
acuerdo de acuerdo desacuerdo desacuerdo
01 Estaria dispuesto/a a hablar de mis
problemas personales si pensara que
podrlaayudarme amioaunmiembro
de mi familia.
02 Siempre tengo curiosidad por las
razones por las cuales la gente actiia
como actiia.
03 Creo que la mayorfa de la gente que
tiene una enfermedad mental tiene algo
mal en el cerebro.
04 Cuando tengo un problema, me siento
mucho mejor si hablo sobre ello con
un/a amigo/a.
05 Con frecuencia no se lo que estoy
sintiendo.
06 Estoy dispuesto/a a cambiar costumbres
antiguas para probar nuevas formas de
hacer las cosas.
07 Hay ciertos problemas que no puedo
discutir con otras personas faera de mi
familia mas inmediata.
08 Con frecuencia me encuentro pensando
sobre que" me hizo actuar en cierto
modo.
09 A veces problemas emocionales pueden
hacerme sentir enfermo/a fisicamente.
10 Cuando tengo problemas, hablar de
ellos con otra gente solo los empeora.
11 Normalmente, si siento una emoci6n
puedo identificarla.
12 Si un amigo/a me diera un consejo sobre
como hacer algo, lo probaria.
13 Me molesta alguien que quiere conocer
mis problemas personales, sea un doctor
ono.
14 Encuentro que despues de desarrollar un
habito es dificil cambiarlo, aunque sepa
que hay otro modo de hacerlo que puede
ser mejor.
 162

Muyde Mas o menos Mas o menos en Muy en

acuerdo de acuerdo desacuerdo desacuerdo
15 Creo que la gente con enfermedades
mentales tienen problemas desde su
niliez.
16 Con frecuencia hace sentirse mejor
desahogarse hablando con alguien sobre
sus problemas.
17 La gente a veces dice que achio como si
estuviera sintiendo cierta emotion (por
ejemplo enojo) cuando yo no soy
consciente.
18 Me molesto cuando la gente me da
consejos sobre c6mo cambiar el modo
c6mo hago las cosas.
19 Para mi no seria diflcil hablar sobre
problemas personales con gente como
doctores o clerigos.
20 Si un buen amigo/a me empezara a
insultar de repente, tal vez mi primera
reaction seria tratar de entender por que
61/ella esta tan enoj ado/a.
21 Pienso que cuando una persona tiene
pensamientos locos, con frecuencia es
porque ti/ella esta muy ansioso/a y
disgustado/a.
22 Nunca he encontrado que hablar con
otra gente sobre mis preocupaciones
ayuda mucho.
23 Con frecuencia, aunque se que estoy
sintiendo una emoci6n, no se que es.
24 Me gusta hacer las cosas como las he
hecho en el pasado. No me gusta
intentar cambiar mucho mi
comportamiento.
25 Hay ciertas cosas en mi vida de las
cuales yo no hablo con nadie.
26 Entender las razones personales por las
cuales actuo de cierta manera es
importante.
27 En el trabajo, si alguien me sugiriera un
modo diferente de hacer un trabajo que
puede ser mejor, lo intentarfa.
28 Encuentro que cuando hablo sobre mis
problemas con alguien mas, encuentro
modos de resolverlos en los que no
habia pensado antes.
29 Soy sensible a los cambios en mis
propios sentimientos.
30 Cuando aprendo un modo nuevo de
hacer algo, me gusta intentarlo para ver
si funciona mejor que lo que he estado
haciendo antes.
 163

Muy de Mas o menos Mas o menos en Muy en

acuerdo de acuerdo desacuerdo desacuerdo
31 Es importante ser abierto y honesto
cuando uno/a habla sobre sus problemas
con alguien de confianza.
32 Yo disfruto tartar de enternder la forma
de personas.
33 Pienso que la mayoria de gente con
problemas mentales tal vez recibio
algun tipo de dafio en su cabeza.
34 Hablar con otra persona sobre sus
preocupaciones le ayuda a entender sus
problemas mejor.
35 Usualmente estoy al tanto de mis
sentimientos.
36 Me gusta intentar nuevas cosas, aunque
ello signifique tomar riesgos.
37 Seria muy diflcil para mf discutir
aspectos de mi vida personal que son
inquietantes o vergonzosos con la gente,
aunque tenga confianza con ellos/as.
38 Si de repente perdiera la paciencia con
alguien, sin saber exactamente por que,
mi primer impulso seria olvidarlo.
39 Creo que el tipo de ambiente de una
persona (familia, etc.) tiene poco que
ver con si esa persona desarrolla
problemas mentales.
40 Cuando tiene problemas, hablar con
alguien mas sobre ellos solamente le
confunde mas.
41 Yo frecuentemente no quiero atender
muy profundo en lo que estoy sintiendo.
42 No me gusta hacer cosas si existe la
posibilidad de que no van a funcionar.
43 Yo pienso que aunque trabaje duro,
nunca entendere que mueve a otras
personas.
44 Pienso que lo que sucede en lo profundo
de la mente de una persona es
importante en determinar si van a tener
una enfermedad mental.
45 El miedo a la vergiienza o el fracaso no
me detiene a la hora de intentar nuevas
cosas.
 164

APPENDIX B
PSYCHOLOGICAL GENERAL WELL-BEING SCHEDULE— SPANISH
TRANSLATION
 Lista de el bienestar psicologico en general
The psychological General Well-Being Schedule

Esta seccion de la investigacion contiene preguntas sobre como se siente

y como le a hido. Para cada pregunta ponga un circulo en el numero de
la respuesta que mas aplica a usted.
1. Como se ha sentido en general? (Durante el ultimo mes)
5 En excelente humor
4 En muy buen humor
3 En buen humor
2 Mi humor ha subido y bajado mucho
1 En bajo humor en mayor parte
0 En muy bajos humores
2. Que seguido ha sido molestada por alguna enfermedad, desorden del cuerpo o
dblores? (Durante el ultimo mes)

0 Todos los dias

1 Casi todos los dias
2 Como la mitad del tiempo
3 Cada cuando, pero menos que mitad del tiempo
4 Raras veces
5 Nunca
3. Se sintio deprimida? (Durante el ultimo mes)
0 Si- al punto que senti deseo de tomar mi propria vida
1 Si- al punto que no me importava nada
2 Si- muy deprimida casi todos los dias
3 Si- bastante deprimida varias veces
4 Si- un poco deprimida cada cuando
5 No- nunca me senti deprimida
4. A estado en control firme de su comportamiento, pensamientos, emociones, o
sentimientos? (Durante el ultimo mes)
5 Si- definitivamente
4 Si- por la mayor parte
3 En general
2 No muy bien
1 No, y estoy algo inquieta (trastornada)
0 No, y estoy muy inquieta (trastornada)
5. Ha sido molestada por nerviosismo o sus "nervios." (Durante el ultimo mes)
0 Muchisimo, hasta el punto de que no pude trabajar o terminar cosas
1 Mucho
2 Bastante
3 En parte—lo suficiente para molestarme
4 Un poco
5 Nunca
6. Cuanta energia, o vitalidad tuvo o sintio? (Durante el ultimo mes)
5. Muy llena de energia
4. Con bastante energia la majoria del tiempo
3. Mi nivel de energia vario bastante
2. Baja en energia en general
1. Muy baja en energia casi todo el tiempo
0. Sin energia en lo total—me senti agotada
7. Yo me senti desanimada y triste durante el ultimo mes.
5. Nunca
4. Un poco de tiempo
3. En parte de tiempo
2. Una buena cantidad de tiempo
1. La major parte del tiempo
0. Todo el tiempo
8. Se sentio tensa en general o sentio alguna tension? (Durante el ultimo mes)
0. Si—muchisima tension, la mayoria o todo el tiempo
1. Si—Muy tensa la mayoria de tiempo
2. En general no, pero si senti bastante tension varias veces
3. Me senti un poco tensa algunas veces
4. Mi nivel de tension en general fue muy baja
5. Nunca me senti tensa o alguna tension
9. Que de feliz, contenta o satisfecha con su vida personal ha estado? (Durante el
ultimo mes)
5. Extremadamente feliz—no podria estar mas satisfecha o contenta
4. Muy feliz la mayoria del tiempo
3. Satisfecha en general-contenta
2. Aveces bastante feliz, aveces bastante infeliz
1. Dissatisfecha en general, infeliz
0. Muy dissatisfecha o infeliz la mayoria de tiempo
10. Se sintio suficiente en buena salud para hacer las cosas que le gusta hacer o tenia
que hacer? (Durante el ultimo mes)
5. Si~difmitivamente
4. Por la mayoria
3. Problemas de salud me limitaron en formas importantes
2. Yo solo estaba lo saludable para solamente cuidarme a mi misma
1. Necesite alguna ayuda para cuidarme a mi misma
0. Necesite ayuda de alguien para hacer la mayoria o todo lo que necesitaba hacer
11. Se ha sentido triste, desanimada, desesperada, o tuvo tantos problemas que se
pregunto si algo valia el tiempo? (Durante el ultimo mes)
0. Muchisimo—hasta el punto de que casi me di por vencida
1. Mucho
2. Bastante
3. En parte—lo suficiente para molestarme
4. Un poco
5. Nunca
12. Me disperte sintiendo rejuvenecida y descansada durante el ultimo mes.
0. Nunca
1. Un poco de tiempo
2. En parte de tiempo
3. Una buena cantidad de tiempo
4. La major parte del tiempo
5. Todo el tiempo
13. Ha estado preocupada o tenido algun temor sobre su salud? (Durante el ultimo
mes)
0. Muchisimo
1. Mucho
2. Bastante
3. En parte—pero no mucho
4. Casi nunca
5. Nunca
14. Ha tenido alguna razon de pensar si estaba perdiendo la mente o perdiendo
control sobre el modo que actua, habla, piensa, siente o su memoria? (Durante el
ultimo mes)
5. Enningunmodo
4. Solo un poco
3. En parte—pero no lo suficiente para estar preocupada sobre esto
2. En parte—y he estado preocupada un poco
1. En parte—y estoy bastante preocupada
0. Si, mucho y estoy muy preocupada
15. Mi vida diaria estaba llena de cosas que me interesan a mi durante el ultimo mes.
0. Nunca
1. Un poco de tiempo
2. En parte de tiempo
3. Una buena cantidad de tiempo
4. La major parte del tiempo
5. Todo el tiempo
16. Se sintio activa, con energia o aburrida y lenta? (Durante el ultimo mes)
5. Muy activa, con energia todos los dias
4. Por la mayor parte activa, con energia—nunca aturdida o lenta
3. Bastante activa, con energia—raramente aturdida o lenta
2. Bastante aturdida y lenta—raramente activa, con energia
1. Por la mayor parte aturdida y lenta—nunca activa, con energia
0. Muy aturdida y lenta todos los dias
17. Ha estado ansiosa, preocupada o disgustada? (Durante el ultimo mes)
0. Muchisimo, al punto de estar enferma o casi enferma
1. Mucho
2. Bastante
3. En parte—lo suficiente para molestarme
4. Unpoco
5. Nunca
 18. Yo estaba estable emocionalmente y segura de mi misma durante el ultimo mes.
0. Nunca
1. Un poco de tiempo
2. En parte de tiempo
3. Una buena cantidad de tiempo
4. La major parte del tiempo
5. Todo el tiempo
19. Se sintio relajada, y tomo cosas con mas calma o se sintio tensa, nerviosa y
excitable durante el ultimo mes.
5. Me senti relajada y calmada durante todo el mes
4. Me senti relajada y calmada por la mayor parte de tiempo
3. Me senti relajada en general pero a tiempos me senti bastante excitable
2. En general excitable pero a tiempos me senti bastante relajada
1. Me senti excitable, nerviosa y tensa por la mayoria de tiempo
0. Me senti excitable, nerviosa y tensa todo el mes
20. Yo me senti animada y alegre durante el ultimo mes.
0. Nunca
1. Un poco de tiempo
2. En parte de tiempo
3. Una buena cantidad de tiempo
4. La major parte del tiempo
5. Todo el tiempo
21. Yo me senti cansada, gastada, agotada durante el ultimo mes.
5. Nunca
4. Un poco de tiempo
3. En parte de tiempo
2. Una buena cantidad de tiempo
1. La major parte del tiempo
0. Todo el tiempo
22. Alguna vez ha estado o sentido tension, estres o se a visto presionada durante el
ultimo mes.
0. Si, casi mas que lo que puedo soportar o aguantar
1. Si, bastante presion
2. Si, alguna—mas que lo usual
3. Si, alguna—pero como lo usual
4. Si un poco
5. Nunca
 169

APPENDIX C

DEMOGRAPHIC QUESTIONNAIRE—ENGLISH VERSION

 170

Demographic Questionnaire—English
Subject Number Today's Date
Age Gender

Marital Status:
Married
Single
Separated
Divorced
Widow

Race/Ethnicity: Where were you born?

United States Puerto Rico
Santo Domingo Mexico
Ecuador El Salvador
Other (specify)

If you were born in a foreign country, how many years have you lived in the United
States?

Where was your father born?

United States Puerto Rico
Santo Domingo Mexico
Ecuador El Salvador
Other (specify)

Where was your mother born?

United States Puerto Rico
Santo Domingo Mexico _____
Ecuador El Salvador
Other (specify)

What is your educational level (highest grade completed?) Please circle one.

0 1 2 3 4 5 6 7 8 9 1 0 1 1 12 college graduate school

What is your employment status? Please circle one.

Full-time Part-time Unemployed

What is your yearly household income (approximately)? Please circle one.

$0-10,000 $10,001-20,000 $20,001-30,000 $30,001-40,000 $40,001-50,000

$50,001 +

History of psychological treatment months?

 171

APPENDIX D

DEMOGRAPHIC QUESTIONNAIRE—SPANISH VERSION

 172

Preguntas Demograficas
Numbero de Participante Fecha _
Edad Sexo

Estado Matrimonial:
Casado/a
Soltero/a
Separado/a
Divorciado/a

Origen Etnico: Donde nacio usted?

United States Puerto Rico
Santo Domingo Mexico
Ecuador El Salvador
Otro grupo etnico (por favor especifique)

Si usted nacio en un pais extranjero, por cuanto tiempo ha vivido en los Estados Unidos?
(Por favor de el numero de anos)

Donde nacio su padre?

United States Puerto Rico
Santo Domingo Mexico
Ecuador El Salvador
Otro grupo etnico(por favor especifique)

Donde nacio su madre?

United States Puerto Rico
Santo Domingo Mexico
Ecuador El Salvador
Otro grupo etnico(por favor especifique)

Cuantos anos de educacion tiene usted? Por favor de rodear con un circulo el numero del
grado mas alto que completo.

0 1 2 3 4 5 6 7 8 9 1 0 1 1 12 colegio escuela graduante

Cual es su estado de empleo? Rode con un circulo.

Tiempo completo Tiempo partial No esta empleada

Que son los ingresos de su casa (aproximadamente)? Rode con un circulo.

$0-10,000 $10,001-20,000 $20,001-30,000 $30,001-40,000 $40,001-50,000

$50,001 +

Experiencia con terapia psychologica meses?

 173

APPENDIX E

INFORMED CONSENT—ENGLISH VERSION

 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Office of Institutional Board of Research Associates

NYU School of Medicine
550 First Ave. Building #VET
10 West
NY, NY 10016
Phone: 212.263.4110
Fax: 212.263.4147
Principal Investigator: Carmen Vazquez, Ph.D.
Co-investigator: Nerina Garcia, MA

ENGLISH INFORMED CONSENT FORM TO PARTICIPATE"AND AUTHORIZATION" FOR

RESEARCH

[TITLE OF RESEARCH

DilfumtiilPiedHtoTs ot Ps> tholo„n ilWUI btin^ i m I itmo'K Jinicil Sunpk

[A PURPOSE OF"THE STUDY" ~~~ ~ ~_7

You are being asked to volunteer in a research study. This consent/authorization form includes
information about this study. The purpose of this study is to learn mere about Latino/as and the
relationship between their personality and subjective well-being, or how people feel. Also we
are trying to identify if psychological mindedness, or how insightful people are, and
culturation, or how individuals adjust to a new culture, are associated with subjective well-
~ding. You are being asked to participate in this study because your participation will contribute
to the scientific knowledge about Latino/a's personality and their mental health. You might feel
satisfaction by discussing your health and well-being.
| B. SUBJECT PARTICIPATION:" ' " ^ ~ j

We estimate that the following number of subjects will enroll in this study:
At this site: 200 Total at all sites: 200

SUBJECT PARTICIPATION:

• Outpatient

Your participation will involve one visit, which will take approximately 30 minutes.

If you decide to participate, you will receive a packet with 6 questionnaires that ask for
information related to personality,, well-being, health, acculturation and psychological
1 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB).
/-~*>ly the IBRA-stamped approved fonv may be used.

Approved: From: p<$-AX-£tin(. To: P T S P ^ - w t a P ? NYU8QM

The study expiration date applies for this form
Template rev. date: 6/9/2003 •. '"
IRB APPROVED
NYU english consent with study data
 H#: 12785-B Consent Version Date: 07/14/05

Office of Institutional Board of Research Associates

NYU School of Medicine
mindedness(insightfulness). The questionnaires will be in English or Spanish depending on the
language you prefer and feel most comfortable. If you prefer, the questions can be read aloud
to you by a research assistant. The packet will take approximately 45 minutes to complete.

Answers to all the questions will be kept confidential. No identifying information will be released
without your consent and your personal information will be protected as specified by the ethics
code of the American Psychological Association and New York law. The packets will be assigned
a code number, and no name or personal information will be included.

[^ COSTS/REIMBURSEMENTS " ^ _ ~ J

There will be no direct costs to you. Nor will you be paid for participating in this study. The
services you receive at this clinic, now and in the future, will not be impacted in any way by
refusing to participate.

E. POTENTIAL RISKS AND DISCOMFORTS: _ _ _ J

The following are risks and .discornfQrts..that.yjou:rhay:.experience: durirag,yo:ur„participation Jh-'this .z

research study. There are no known risks associated with participating in this research. You
might feel some emotional distress as a result of discussing your health and well-being. If you
~"'o feel any emotional distress related to participation in this study you can ask the research
osistant to move on to the next question or if you are filling out the form you may skip that
question. You can withdraw from this study at any time.

E, 'POTENTIAL BENEFITS:: ._ _

There is no direct benefit to you expected from your participation in this study. It is hoped the
knowledge gained will be of benefit others in the future.

| : G. ALT.ERNATJVESTP P-ARTICI EATING IN t-HE STO'PX O ; . > . -

This is not a study related to diagnosis or treatment of a disease or condition in eligible subjects.
You are free to choose not to participate in the study.

a&^iiiii^^
Private information about you that identifies you may be used or shared for the purposes of this
research project. This section of the consent/authorization form describes how your information

2 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB),
~"*>n/y the IBRA-stamped approved form may be used.

Approved: From- 0^2Ss2DCC T°m-69-~AV^lQG3. NYUSOfo-

The study expiration date applies for this form
Template rev. date: 6/9/2003 , Em APPROVED
NYU english consent with study data
 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Office of Institutional Board of Research Associates

____ NYU School of Medicine
will be used and shared in this research, and the ways in which NYU School of Medicine will
safeguard your privacy and confidentiality.

Other persons and organizations, including co-investigators, federal and state regulatory
agencies, and the~IRB(s) overseeing the research may receive y o u r information during the
course of this study. Except when required by law, study information shared with persons and
organizations outside of New York University School of Medicine (NYUSM) will not identify you by
name, social security number, address, telephone number, or any other direct personal
identifier.

When your study information will be-disclosed outside of NYUSM as part of the research, the
information that can identify you as listed above will be removed and your records will be
assigned a unique code number. NYUSM will not disclose the code key, except as required by
law.

Confidentiality of Your Medical Records

Your medical records will be kept in accordance with state and federal laws concerning the
- -privacy and confidervtialit^of medical information. If your, participation JriJiusTjeaaardxis fee
"'""' treatment ordiaghosde'p^ treated may" a-sk" yon to5 sigrra - :

separate informed consent document for specific procedures or treatment, and that informed
^-consent form may be included in the medical record of that facility. The confidentiality of your
nedical record is also protected by federal privacy regulations, as described below.

Confidentiality of Your Study Information

Your study records include information that identifies you and that is kept in research files. We
will try to keep this information confidential, but we cannot guarantee it. I f data from this study
are to be published or presented, we will first take out the information that identifies you.

Retention of Your Study Information

The study results will be kept in your research record for at least six years or until after the
study is completed, whichever is longer. At that time either the research information not
already in your medical record will be destroyed or information identifying you will be removed
from such study results at NYU. Any research information in your medical record will be kept
indefinitely.

Your HIPAA Authorization

A new federal regulation, the federal medical Privacy Rule, has taken effect as required by the
Health Insurance Portability and Accountability Act (HIPAA). Under the Privacy Rule, in most
cases we must seek your written permission to use or disclose identifiable health information
about you that we use or create [your protected health information"] in connection with
3 of 9 - Subject's Initials: Date: .

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB).
^Only the IBRA-stamped approved form may be used.

Approved; From: {ft^S-loot To: o>9r£<SrJ><y»? NYUSOM

The study expiration date applies for this form
Template rev. date: 6/9/2003 RB APPROVED
NYU english consent with study data
 H#: 12785-B Consent Version Date: 07/14/05

Office of Institutional Board of Research Associates

N Y U School o f M e d i c i n e
research involving your treatment or medical records. This permission is called an
Authorization.

If you sign this form you are giving your Authorization for the uses and sharing of your protected
health information described below.' Your havea right to refuse to sign this form. If you do not
sign the form you may not be in the research program, but refusing to sign will not affect your
health care (or payment for your health care) outside the study.

This Authorization will not expire unless you withdraw it in writing. You have the right to
withdraw your authorization at any time, except to the extent that NYU has already relied upon
it or must continue to use your information to complete data analysis or to report data for this
study. The procedure for revoking your authorization is described below in Section K.

By signing this form you authorize the use and disclosure of the following information for this
research:

• Clinical and research observations made during your participation in the research.

"By signing this form'yoa'authdrize the fC5llowlng"persons'a'tid organizations to" receive" yoor
protected health information for purposes related to this research:

• Every research site for this study, including this hospital, and including each sites' research
staff and medical staff
• The following research sponsors and the people and companies they use to oversee,
administer, or conduct the research: Fordham University
• The United States research regulatory agencies and other foreign regulatory agencies
• The members and staff of the hospital's affiliated Institutional Review Board
• The members and staff of the hospital's affiliated Privacy Board
• Principal Investigator: Carmen Vazquez, Ph.D.
• Study Coordinator
• Members of the Research Team
• The Patient Advocate or Research Ombudsman (GCRC)
• Data Safety Monitoring Board/Clinical Events Committee
• Others (as described below):

If any of the companies or institutions listed above merges or is sold during the course of this
research, your Authorization will cover uses and disclosures of your protected health information
to the new company or institution that assumes responsibility for the research.

4 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB).
-j?nly the IBRA-stamped approved form may be used.

Approved: From: 0%2.S - ?*o{ To: oV-ltfrZGbZ

The study expiration date applies for this form
Template rev. date: 6/9/2003
NYU english consent with study data
 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Office of Institutional Board of Research Associates

NYU S c h o o l o f Medicine
Please be aware that once your protected health information is disclosed to a person or
organization that is not covered by the federal medical Privacy Rule, the information is no longer
protected by the Privacy Rule and may be subject to redisclosure by the recipient.

li»iiilMi^^iail
All forms of medical (or mental health) diagnosis and treatment - whether routine or
experimental - involve some risk of injury. In addition, there may be risks associated with this
study that we do not know about.

If you sustain any injury during the course of the research, please contad^elP^njricipal
Investigator Carmen Vazquez, Ph.D. at the following telephone number J l l i i l l i i l l S l l f such
complications arise, the study doctor will assist you in obtaining appropriate medical treatment
but this study does not provide financial assistance for medical or other injury-related costs.
You do not give up any rights to seek payment for personal injury by signing this form.

Your decision as to whether or not to take part in this study is completely voluntary (of your free
will). If you decide not to take part in this study it will not affect the care you receive and will
l o t result in any loss of benefits to which you are otherwise entitled.

You will be told of any significant new findings developed during the course of the research that
may influence your willingness to continue to participate in the research.

Your decision as to whether to give your Authorization for the use and disclosure of your
protected health information for this study is also completely voluntary; however, if you decline
to give your Authorization or if you withdraw your Authorization you may not participate in the
study.

The principal investigator of this study, Carmen Vazquez, assures that

participation in this research study completely voluntary (of your free will).
If you decide not to take part in this study it will not affect the care you
receive at the center.

5 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York Universit/s Institutional Review Board (IRB)
/—Only the IBRA-stamped approved form may be used.

Approved: From: ^>Q.->2g'- 2/jf>£To: h ? ' 2 . V.- 2&fl7 NYDSDH

The study expiration date applies for this form IRB APPROVED
Template rev. date: 6/9/2003
NYU english consent with study data
 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Office of Institutional Board of Research Associates

NYU School o f Medicine
If you decide to take part in the study, you may withdraw from participation at any time without
penalty or loss of benefits to which you would otherwise be entitled. You may also withdraw
your Authorization for us to use or disclose your protected health information for the study.
If you dodecide to withdraw your consent, we ask that you contact Dr. B H f l B H | [ H ! ! l v v r n : , n a -
and let g know that you are wjthdrawinq from the" study: *
fnl Piogram Chnic, Ne\ """"1 ^^r~~~~—~r-^-~-~-^
™ Yor k, NY 10016 If you wish to withdraw your Authorization as well as your consent
to be in the study, you must contact Dr. | | £ ^ P £ R & H S in writinq. WfS^rW^&fSSm^SSf^S^S^I
feilW

Remember that withdrawing your Authorization only affects uses and sharing of information
after your written request has been received, and you may not withdraw your Authorization for
uses or disclosures that we have previously made or must continue to make to complete
analyses or report data from the research.

The Principal Investigator or another member of the study team will discuss with you any
..xacisiderations involvedin discontinuing.your.partieipatiorkin.the.study. Yoit-will.then be. .
:
• Withdrawn from trre study: ~ --- . - . , . . .-. •- ._•

I PERMISSION TO CONTACT YOU ABOUT FUTURE RESEARCH: i •* • * i

I authorize the principal investigator and his or her co-investigators to contact me about future
research on M B ^ H ^ H within the ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ S i provided that this future research is
approved by the original IRB of record and that the principal investigator and co-investigator are
affiliated with the research p r o t o c o L ^ ^
If I agree, then someone from Dr. f S M l l i ' s research staff might contact me in the future and
he or she will tell me about a research study. At that time, I can decide whether or not I am
interested in participating in a particular study. I will then have the opportunity to contact the
researcher to schedule an appointment to be fully informed about the research project.

6 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB)
"Only the IBRA-stamped approved form may be used.

Approved:From: *rt-J*3-2r3&£ To: Q?'-2t/-2oo?

The study expiration date applies for this form NYUS6M
Template rev. date: 6/9/2003 1PB APPROVED
NYU english consent with study data
 H#: 12785-B Consent Version Date: 07/14/05

Office of institutional Board of Research Associates

' N Y U School o f M e d i c i n e
• I agree to be contacted by the Principal Investigator or Co-Investigators of the research
study titled: (insert title of study) •

• I do not want to be contacted by the Principal Investigator or Co-Investigator of the

research study'titled: ~ * - <•-•*> *

Signature of participant or legal representative Date

Your permission to allow us to contact you about future research would be greatly appreciated,
but it is completely voluntary. I f you choose not to allow us to contact you, it will not affect your
care at any of the IMYUSM facilities. Please understand that giving your permission to do this is
only for the purpose of helping us identify subjects who may qualify for one of our future
research studies. I t does not mean that you must join in any study.

; ' ^ — 1 — > —
the manner in which this study is'being conducted and would like" to discuss your participation
with an institutional representative who is not part of this study, please contact the
" A d m i n i s t r a t o r , Institutional Board of Research Associates, Telephone No. 212-263-4110.

I f you have any questions or sustain any injury during the course of the research or experience
any adverse reaction to a study drug or procedure, please oontajct t ^ P r i n c i p a l Investigator
Carmen Vazquez, Ph.D. at the following telephone number ^ ^ ^ ^ ^ ^ ^ S

AGREEMENT TO PARTICIPATE AND AUTHORIZATION FOR THE USE OR DISCLOSURE OF

PROTECTED HEALTH INFORMATION:

Part of the consent process includes your Authorization to use Protected Health Information for
the purposes of this study, as described above. If you do not want to authorize the use of this
PHI, you should not agree to be in this study.

• I have read this consent form

or
• it was read to me by: .

Any questions I had were answered by: .

I • am • am not participating in another research project at this time.

7 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB).
Only the IBRA-stamped approved form may be used.

Approved: From: AftrAS.-,?*x*CTo: /*4**2&r2a*2-

The study expiration date applies for this form
NYUSOM
Template rev. date: 6/9/2003 m APPROVED
NYU english consent with study data
_H#: 12785-B
Consent Version Date: 0 7 / 1 4 / 0 5
Office of Institutional Board of Research Associates
N Y U School of Medicine
(If yes, you should discuss this with your study doctor.)

I voluntarily agree to participate in this research program at:

• B e l l e v u e Hospital Center: this form and your study information will be available to Bellevue
Hospital administration and their auditors.

I understand that I am entitled to and will be given a copy of this signed Consent/Authorization
Form.

By signing this Consent/Authorization form, I give my Authorization for the uses and disclosures
of my protected health information as described above.

WHEN THE SUBJECT I S AN ADULT '

Notice Concerning HIV-Related Information

recipient(s) is prohibited from redisclosing any HIV-related information without your

authorization unless permitted to do so under federal or state law. You also have a right to
request a list of people who may receive or use your HIV-related information without
authorization. If you experience discrimination because of the release or disclosure of HIV-
related information, you may contact the New York State Division of Human Rights at (212) 480-
2493 or the New York City Commission of Human Rights at (212) 306-7450. These agencies are
responsible for protecting your rights.

* For subjects who may not be capable of providing informed consent, the signature of a legal"
representative is required. For a valid HIPAA authorization, the "personal representative" must
have authority under state law to make health care decisions for the subject.

; /
Print Name of Participant Signature of Participant Date
or Legal Representative* or Legal Representative*

7_
Print Name of Person Signature of Person Date
Obtaining Consent Obtaining Consent

8 of 9 Subject's Initials: . Date:

(IRB Official Use Only)

This Consent Document is approved for use by the New York University's Institutional Review Board (IRB)
Only the IBRA-stamped approved form may be used.

Apprvve&Erom: r&'J&^ooZ To: fi9-2^2Loo^ NYUSOM...*

The study expiration date applies for this form IRB APPROVED
Template rev. date: 6/9/2003
NYU english consent with study data
 ITf -,"-" i" ?*•«*,.,»

M f ^s- ' W
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Office of Institutional Board of Research Associates

N Y U School o f M e d i c i n e
* * When the elements of informed consent are presented orally to the subject or representative,
a witness to the oral presentation is required. [NOTE: it is unclear whether HIPAA
authorization may be presented orally - this might require an IRB waiver to permit alteration of
the form of authorization]

I
Print Name of Witness** Signature of Witness** Date

>• *prprf—rM— w *T^t+ «**"r*«0ifev*™-*-«r<. » H i «

9 of 9 Subject's Initials: Date:

(IRB Official Use Only)

This Conserif'Document is approved for use by the New York University's Institutional Review Board (IRB).
^s~<Only the IBRA-stamped approved form may be used.

Approved: From: h^ZS'ZooC To: frff^y- flm?-

The study expiration date applies for this form
NYUSOM"
Template rev. date: 6/9/2003
NYU english consent with study data
IRB APPROVED
 183

APPENDIX F

INFORMED CONSENT— SPANISH VERSION

 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Oficina del Consejo Institucional Office of Institutional Board

e Investigadores Asociados of Research Associates
Facultad de Medicina de la Universidad de Nueva York N Y U School o f M e d i c i n e

9
550 First Ave. Building #VET
10 West
NY, NY 10016
Telefono: 212.263.4110
Fax: 212.263.4147

Investigador/a Principal: Carmen Vazquez, Ph.D.

Co-investigador/a: Nerina Garcia, MA

FORMULARIO DE CONSENTIMIENTO INFORMADO Y AUTORIZACION PARA PARTI CI PAR

EN UNA INVESTIGACION

TITULO DE LA INVESTIGACION:

Indicadores de el bienestar subjetiyo en Ujn gjrupo clinicode Latino/as: Differential Predictors

of Psychological Well-being in a Latino/a Clinical Sample n

A . P R O P O S I T O DEL E S T U D I O :

Se le esta pidiendo que participe en un estudio de investigation. Este formulario de

N consentimiento/autorizacion incluye informacion sobre este estudio. El proposito del estudio es
aprender mas informacion sobre Latino/as, y explorar la relacion entre la personalidad y el
bienestar subjetivo, o como se siente. Mi investigacion trata de identificar si hay una relacion
entre la salud mental y bienestar de una persona y como de introspective es, y el ajuste a una
nueva cultura.
Se le esta pidiendo que participe en este estudio porque su participacion contribuira al
conocimiento cientifico de la personalidad de Latino/as y la salud mental con el ajuste a una
nueva cultura. Tal ves sentira satisfjcacion al hablar sobre su salud y bienestar.

| B. SUJETOS P A R T I C I P A T E S :

Estimamos que participara en este estudio el siguiente numero de sujetos:

En este lugar: 200 Total en todos los lugares: 200

SUJETOS PARTICIPATES:
• Pacientes externos

Su participacion le supondra una visita, que se llevara a cabo durante 30 minutos.

1 de 9 Initiates del sujeto: Fecha: ;

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucional de
Revision) de la New York University (Universidad de Nueva York).
S6lo podrdn utilizarse los formulahos con el sello de aprobacion del IBRA

Aprobado: Desde: o9-JG.2ooCHasta: a?^c/- ZOQ^

La fecha de vencimiento del estudio es aplicable a este formulario
NYUS0M
Fecha de revision de la plantilla: 3/23/03 1PR flPDnnwrn
nyu Spanish consent with study data
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

oficina del Consejo institucionai Office of Institutional Board

'e Investigadores Asociados Of Research Associates
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine

q
C. DESCRIPCION DE LA INVEST|6A€l6ti: : ^ V

Si decide participar, usted recibira un grupo de seis (6) cuestionarios. Los cuestionarios
preguntan informacion acerca de: su personalidad, su bienestar y salud mental, como se ha
ajustado a la cultura Estado Unidense, y su predisposicion psicologica. Puede escojer entre
cuestionarios en Ingles o Espanol. Si prefiere, una asistente de la investigacion puede leerle las
preguntas. Los cuestionarios se tomara aproximadamente 30 minutos para completarse.

Respuestas a todas las preguntas seran confidenciales. Ninguna informacion que le identifique
personalmente sera revelada sin su permiso separado su informacion personal recibira la
protection al limite de la ley de el estado de Nueva York, HIPAA y al especificado de el codico de
etica de la Asociacion Americana de Psicologia. El paquete de cuestionarios recibira un numero
de clasificacion, su nombre o informacion personal no sera incluida.

D. COSTOS / REEMBOLSOS:

No hay costo directo para usted. No recibira beneficios directos por su participacion en este
projecto de investigacion. Su participacion no es obligatoria. Los servicios que recibe en esta
clinica, hoy y en el futuro, no seran afectados si no quiere participar.

E. POSIBLES RIES60S EylNCOMOPIPADESi

Los siguientes riesgos o incomodidades podrfan surgir por participar en este estudio de
investigacion.

No se conoce peligros asociados con participacion en esta investigacion. Si siente incomodidad

al participar en este projecto puede pedirle a la asistente de la investigacion que le pregunte la
proxima pregunta o si used esta completando los cuestionarios puede seguir a la proxima
pregunta. Puede terminar su participacion en la investigacion cuando desee.

F. PQSIBfcES BENEEICf0S,t , . . ' ' _" ' , « - t w « , ••''-> '. .< > ?•••.'/
; V
" ' * . * 1 •" -. v ',. • -'v ^JttfS'Vv #,' $&-, V :!'u **', *>;."'
No se espera que haya un beneficio directo para usted por su participacion en este estudio.
Esperamos que los conocimientos adquiridos puedan beneficiar a otras personas en el futuro.

2de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revisidn) de la New York University (Universidad de Nueva Yori<).
Solo podran utilizarse los fonnularios con el sello de aprobacidn del IBRA

Aprobado: Desde: 69-2-5-200£ Hasta: to^-tZV-Zan? NYUSOM

La fecha de v e n c i m i e n t o del estudio es aplicable a este f o r m u l a r i o
IRB APPROVED
Fecha de revisidn de la plantilla: 3/23/03
nyu Spanish consent with study data
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

oficina del consejo institucionai Office of Institutional Board

e Investigadores Asoeiados Of Research Associates
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine
G. ALTERNATIVAS A LA PARTICIPACION EN EL ESTUDIO
Este estudio no se trata de un estudio relacionado con el diagn6stico o tratamiento de una
enfermedad, afeccion o condicion en los sujetos que cumplen con los requisitos. listed es libre
de decidir no participar en este estudio.

H. CONFIDENCIALIDAD:

La informacion privada que le pueda identificar podrfa ser utilizada o compartida para los
propositos de este proyecto de investigacion. Esta seccion del consentimiento/autorizacion
describe como su informacion sera utilizada y compartida en esta investigaci6n, y de que formas
la NYU School of Medicine (Facultad de Medicina de IMYU) protegera su privacidad y
confidencialidad.

Si usted accede a participar en este'programa de investigacion, la Dra. Carmen Vazquez, Ph.D. y

su equipo de investigacion le pediran que se complete 6 cuestionarios. ^ ^ B ^ B utilizara los
resultados de esta evaluation para completar esta investigacion. Los resuitados de estas
evaluaciones no se mantendran en su historial medico.

Otras personas u organizaciones, incluyendo los co-investigadores, las agendas reguladoras

federales y estatales y lo/s Consejo/s Institucional/es de Revision (IRB) encargado/s de
supervisar la investigacion, podrfan recibir su informacion durante el curso de este estudio.
Excepto a cuando la ley lo exija, la informacion del estudio que se comparta con personas y
organizaciones fuera de la New York University School of Medicine (NYUSM - Facultad de
Medicina de la Universidad de Nueva York) es Fordham University, no le identificara por su
nombre, numero de seguro social, direction, numero de telefono o cualquier otro identificador
personal directo.

Cuando su informacion del estudio sea revelada fuera de la NYUSM como parte de esta
investigacion, la informacion que lo pueda identificar del modo citado anteriormente, sera
eliminada, y se asignara un numero'de codigo unico a sus archivos. La NYUSM no revelara la
clave de codigo, a no ser que la ley lo exija.

Confidencialidad de sus archivos medicos

Sus archivos medicos se guardaran de acuerdo con las leyes estatales y federales concernientes
a la privacidad y confidencialidad de la informaci6n medica. La confidencialidad de su informe
medico tambien esta protegida por las leyes de privacidad federales, como se describe mas
abajo.

3de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento esta aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New York University (Universidad de Nueva York).
Solo podran utilizarse los formularios con el sello de aprobacidn del IBRA

Aprobado: Desde: n*>'25-?c?n£ Hasta: r& -2<S- Zoo!

La fecha d e v e n c i m i e n t o del estudio es aplicable a este f o r m u l a r i o
NYUSOM
IRB APPROVED
Fecha derevisi6nde la plantilla: 3/23/03
nyu Spanish consent with study data
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

oficina del consejo institucionai Office of Institutional Board

le investigadores Asociados of Research Associates
Facultad de Medlcina de la Universidad de Nueva York NYU School Of Medicine
Confidencialidad de su informacion del estudio
Sus datos del estudio incluyen informacion que le identifica y que se guarda en los archivos de
investigacion. Intentaremos mantener esta informacion de manera confidencial, pero no se lo
podemos garantizar. Si los datos de este estudio tienen que ser publicados o presentados,
primero extraeremos la informacion que le identifique.

Retencion de su informacion del estudio

Los resultados del estudio seran mantenidos en su archivo de investigacion durante al menos 6
anos o hasta despues de que se haya completado el estudio, si este es mcis largo. En ese
momento, o bien se destruira la informacion de la investigacion que no este ya en su historial
medico, o se extraera de tales resultados del estudio en la Universidad de Nueva York la
informacion que le pueda identificar. Cualquier informacion de la investigacion se mantendra en
su historial medico indefinidamente.

Su autorizacion HIPAA
Una nueva regla federal, la ley federal de privacidad medica, se ha puesto en vigor tal y como lo
exige el Health Insurance Portability and Accountability Act (HIPAA - Ley de movilidad y
responsabilidad del seguro de salud federal). Bajo la ley de privacidad, en muchas ocasiones
debemos conseguir su permiso por escrito para poder utilizar o revelar la informacion medica
que le podrfa identificar, la cual utilizamos o creamos [su "informacion medica protegida"] en
conexion con la investigacion que implica su tratamiento o sus archivos medicos. Este permiso
se llama "Autorizacion".

Si usted firma este formulario, estara dando su Autorizacion para utilizar y compartir su
informacion medica protegida descrita mas abajo. Tiene derecho a negarse a firmar este
formulario. Si no firma este formulario, podrfa no ser incluido en el programa de investigacion,
pero por negarse a firmar este formulario, no se vera afectada la atencion medica que usted
reciba al margen del estudio (o el pago por esa atencion medica).

Esta Autorizacion no vencera a no ser que usted la anule por escrito. Tiene derecho a anular su
autorizacion en cualquier momento, excepto hasta el punto en el que NYU ya la haya utilizado, p
si ha de seguir utilizando su informacion para completar el analisis de datos o para informar de
los datos de este estudio. El procedimiento para anular su autorizacion esta descrito mas abajo,
en la seccion K.

Firmando este formulario, usted autoriza la utilizacion y revelacion de la siguiente informacion

para esta investigacion:

• Sus archivos de la investigacion

4de9 Iniciales del sujeto: Fecha:

(Solamente para utilizacion oficial del IRB)

Este Documento de Consentimiento esti aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New York University (Universidad de Nueva York).
Solo podr&n utilizarse los formularios con el sello de aprobacidn del IBRA

Aprobado:Desde:(fl-2£Zcof Hasta:s>*)-2if-2oc>'J NYUSOM

La fecha de vencimiento del estudio es aplicable a este formulario IRB APPROVED
Fecha de revisibn de la plantilla: 3/23/03
nyu Spanish consent with study data
 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

^ficina del consejo institucionai Office of Institutional Board

e Investigadores Asoeiados Of Research Associates
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine
• Observaciones clmicas y de investigacion realizadas durante su participation en la
investigation.

Firmando este formulario, usted autoriza a las siguientes personas y organizaciones a recibir su
informacion medica protegida para propositos relacionados con esta investigacion:

• Cada lugar donde se lleve a cabo la investigacion para este estudio, incluyendo este hospital
e incluyendo cada lugar donde se encuentre el personal de investigacion y el personal
medico
• Cada profesional de la salud que le ofrezca servicios en conexion con este estudio
• Las agendas reguladoras de investigacion de EE.UU. y otras agencias reguladoras
extranjeras
• Los miembros y el personal del Institutional Review Board (Consejo de Revisi6n
Institucionai) afiliado al hospital
• Los miembros y el personal del comite de privacidad afiliado al hospital
• La investigadora principal: Carmen Vazquez, Ph.D.
• La coordinadora del estudio: Nerina Garcia, M.A.
• Los miembros del equipo de investigacion
• El abogado defensor de los pacientes o el defensor de los sujetos de investigacion (GCRC)
• Data Safety Monitoring Board (Consejo de control de la seguridad de los datos) y/o Clinical
Events Committee (Comite de acontecimientos clinicos)
• Otros (tal y como se describen mas abajo): Fordham University

Si cualquiera de las companias o instituciones enumeradas anteriormente se fusiona o se vende

durante el curso de esta investigacion, su autorizacion cubrira las utilizaciones y revelaciones de
su informacion medica protegida que haga la nueva compania o institucion que asuma la
responsabilidad de la investigacion.

Por favor, tenga en cuenta que una vez su informacion medica protegida es revelada a una
persona u organizacion que no esta cubierta por la ley federal de la privacidad medica, la
informacion no esta protegida ya por la ley de privacidad y puede estar sujeta a una nueva
revelacion por parte del receptor.

1. C J 0 f t P E I ^ C l 6 N 7 t » j J ^ '•. T

Todos los tipos de diagnostico y tratamiento de salud mental, ya sean de rutina o

experimentales, conllevan algun riesgo de dano o lesion. Ademas, podria haber riesgos
asoeiados a este estudio que no conocemos. A pesar de todas las precauciones, usted podrfa
desarrollar complicaciones sicologicas por participar en este estudio.

5de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New Yorfc University (Universidad de Nueva York).
Solo podran utilizarse los formularies con el sello de aprobacidn del IBRA

Aprobado: Desde: aQ-2£-2ooS Hasta: <79'29~2ool

La fecha de vencimiento del estudio es aplicable a este formulario NYUSOM
Fecha de revisibn de la plantilla: 3/23/03
IRB APPROVED
nyu Spanish consent with study data
 H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

joficina del Consejo institucionai Office of Institutional Board

e Investigadores Asociados Of Research ASSOCISteS
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine
Si usted sufre cualquier dano durante el curso de esta investigation o experimenta algun efecto
secundario al procedimiento del estudio, por favor, pongase en £ontacto con la investigadora
principal, Carmen Vazquez, Ph.D., en el numero de telefono ^ ^ ^ g | S l 8 - Si surgieran tales
complicaciones, la investigadora principal le ayudara a obtener un tratamiento medico adecuado,
pero este estudio no ofrece asistencia financiera para gastos medicos o relacionados con dafios.
Por firmar este formulario, usted no renuncia a su derecho de buscar el pago por dafios
personates.

J. PARTICIPACIOJM VOLUNTARIA Y AUTORIZACION: ;

Su decision de si participar o no en este estudio es completamente voluntaria (de su libre

voluntad). Si usted decide no tomar parte en el estudio, esta decision no afectara la atencion
que usted reciba y no resultara en una perdida de los beneficios a los que tiene derecho.

Se le informara de cualquier descubrimiento nuevo significativo desarrollado durante el curso de

la investigation que pudiera influir en su deseo de seguir participando en el estudio.

Su decision de dar su Autorizacion para la utilization y revelation de su information medica

protegida es completamente voluntaria; sin embargo, si usted se niega a dar su autorizacion o si
usted retira su autorizacion, puede que no pueda participar en el estudio.

K. ABANDONO DEL ESTUDIO Y/O RETIRADA DE LA AUTORIZACION:

La investigadora principal de esta investigation, Carmen Vazquez, asegura que su participation

es completamente voluntaria. Si decide no participar su cuidado medico en esta clinica no sera
affectado en ningun modo.

Si usted decide tomar parte en este estudio, podra dejar de participar en cualquier momento sin
penalization o perdida de los beneficios a los que tiene derecho. Tambien podra anular su
autorizacion, lo cual nos autoriza a utilizar o revelar su information medica protegida para el
estudio.

Si usted decide anular su consentimiento, le pedimos que se ponga en contacto con la Dra.
Vazq'^e^por escrito y que le deie saber que va a abandonar el estudio. Su direction decorreo es

asi como su
consentimiento para participar en el estudio, debera ponerse en contacto con la Dra. Vazquez

6de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New York University (Universidad de Nueva York).
S6I0 podran utilizarse los formutarios con el sello de aprobacidn del IBRA

Aprobado: Desde: o<?JlS~2on£ Hasta: (°>%J2V* 2ot,1- NYUSOM

La fecha d e v e n c i m i e n t p del estudio es aplicable a este f o r m u l a r i o
IRB APPROVED
Fecha de revisibn de la plantilla: 3/23/03
nyu Spanish consent with study data
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

oficma del consejo institucionai Office of Institutional Board

,e Investigadores Asociados Of Research ASSOCiateS
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine

Recuerde que retirar su Autorizacion solamente afecta a la utilization de la informacion y a

compartir esta despues de que se haya recibido su solicitud por escrito, y puede que usted no
pueda anular su Autorizacion para las utilizaciones y revelaciones que hayamos hecho
previamente o que tengamos que continuar haciendo, con el fin de completar los analisis o
informal- de los datos de la investigation.

La investigadora principal u otro miembro del equipo del estudio comentaran con usted cualquier
consideration relacionada con su descontinuacion en la participation del estudio. Se le explicara
como retirarse del estudio y se le podria pedir que vuelva para una ultima revision.

L. PERMISO PARA QUE NOS PONGAMOS EN CONTACTO CON USTED RESPECTO A

FUTURAS INVESTIGACIONES: ' '" , '•; " '»;-'!"• - '", V , ; , " , ' v ""-

No es applicable.

M. PERSONAS DE CONTACTO

Para mas informacion sobre sus derechos como sujeto de investigation, o si no esta satisfecho
con la forma en la cual este estudio se esta llevando a cabo, y le gustaria hablar sobre su
participation con un representante institucionai que no sea parte de este estudio, por favor,
ponganse en contacto con el administrador del Institutional Board of Research Associates
(Consejo Institucionai de Investigadores Asociados), en el teleYono N°: 212-263-4110.

Si tiene cualquier pregunta, o si ha sufrido algun dano o lesion durante el curso de la

investigation o experimenta alguna reaction adversa a un medicamento q procedimiento del
estudio, por favor, pongase en contacto con la investigadora p r i n c i p a l , ^ ^ ® e £ ^ ' ^ | a ^ ^ ^ D ^ ,
en el telefono numero 2£J(£i$<>$i-$&$.

ACUERDO DE PARTICIPACION Y AUTORIZACION PARA LA U T I L I Z A C I O N Y

REVELACION DE INFORMACION MEDIC A PROTEGIDA:

Parte del proceso de consentimiento incluye su Autorizacion para utilizar informacion medica
protegida para los propositos de este estudio, tal y como se describia anteriormente. Si usted no
quiere autorizar la utilization de la informacion medica protegida, deberia no acceder a partlcipar
en este estudio.

7de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New York University (Universidad de Nueva York).
Solo podran utilizarse los formularios con el sello de aprobacidn del IBRA

Aprobado:Desde:/&-£<•?fio/T Hasta: rO<?-2tf-2oo3 NYUSOM

La fecha de vencimiento del estudio es aplicable a este formulario
IRB APPROVED
Fecha de revisidn de la plantilla: 3/23/03
nyu Spanish consent with study data
H#: 12785-B
Consent Version Date: 0 7 / 1 4 / 0 5
pficina del consejo institucionai Office of Institutional Board
a investigadores Asociados of Research Associates
Facultad de Medicina de la Universidad de Nueva York NYU School Of Medicine

• He leido este formulario de consentimiento

o
• Me lo ha leido: .

Cualquier pregunta que tuve me la contest6: , .

Estoy • No estoy • participando en otro proyecto de investigation en este momento.

(Si contesta que si lo esta, deberia comentarselo al doctor del estudio)

Accedo a participar voluntariamente en este programa de investigation en:

• Bellevue Hospital Center: este formulario y su information del estudio estaran a disposition
de la administration del Bellevue Hospital y sus auditores.
Comprendo que tengo derecho a firmar este formulario de consentimiento/autorizacion y a
recibir una copia del mismo.

Firmando este formulario de consentimiento/autorizacion, doy mi autorizacion para las

utilizaciones y revelaciones de mi information medica protegida tal y como se ha descrito
anteriormente.

CUANDO EL SUJETO ES UN ADULTO:

Notification concemiente a la information relacionada con el VIH

Si usted esta autorizando la revelation de information relacionada con VIH, debera estar al tanto
que el/los receptor/es de esta information tiene/n prohibido revelar cualquier information
relacionada con el VIH sin su autorizacion por escrito, a no ser que alguna ley federal o estatal
se lo permita. Usted tambien tiene derecho a solicitar una lista de las personas que podrian
recibir o utilizar su information relacionada con el VIH sin su autorizacion. Si usted sufriera

discrimination por la revelation o divulgation de information relacionada con el VIH, podra

ponerse en contacto con el New York State Division of Human Rights (Division para los derechos
humanos del estado de Nueva York) en el numero (212) 480-2493 o con el New York City
Commission of Human Rights (Comision para los derechos humanos de la ciudad de nueva York)
en el numero (212) 306-7450. Estas agencias son responsables de proteger sus derechos.

8de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento este aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucionai de
Revision) de la New York University (Universidad de Nueva York).
S6lo podrSn utilizarse los formularios con el sello de aprobacidn del IBRA

Aprobado: Desde: 6l~?G-2Qt>6 Hasta: J9-2V- ZOO?

La fecha de v e n c i m i e n t o del estudio es aplicable a este f o r m u l a r i o
NYUSOM
Fecha de revisi6n de la plantilla: 3/23/03
IRB APPROVED
nyu Spanish consent with study data
H#: 12785-B Consent Version Date: 0 7 / 1 4 / 0 5

Oficina del Consejo Institucional Office of Institutional Board

e Investigadores Asociados of Research Associates
Facultad de Medicina de la Universidad de Nueva York N Y U School o f M e d i c i n e
* Cuando el sujeto no sea capaz de dar el consentimiento informado, sera necesaria la firma de
un representante legal. Para una autorizacion HIPAA valida, el "representante personal" debe
tener autoridad bajo la ley estatal a'la hora de tomar las decisiones de salud del sujeto.

Nombre del participante Firma del participante Fecha

o representante legal* o representante legal*

Nombre de la persona que Firma de la persona que Fecha

obtiene el consentimiento obtiene el consentimiento

* * Se requerira la presencia de un testigo cuando los elementos del consentimiento informado

se presenten oralmente al sujeto o a su representante. [NOTA: no esta" claro si la autorizacion
HIPPA se presentara oralmente - esto podria requerir una peticion del IRB para permitir la
alteration del formulario de autorizacion]
• /

Nombre del testigo** Firma del testigo** Fecha

9de9 Iniciales del sujeto: Fecha:

(Solamente para utilization oficial del IRB)

Este Documento de Consentimiento esta aprobado para el uso de la Institutional Review Board (IRB - Consejo Institucional de
Revision) de la New York University (Universidad de Nueva Yori<).
Solo podnin utilizarse los fonrtularios con el sello de aprobacion del IBRA

Aprobado:Desde: €f?-JlS'200^ Haste: 69~<2t/-~2o&3

La fecha de vencimiento del estudio es aplicable a este formulario NYUSOM
Fecha de revision de la plantilla: 3/23/03
IRB APPROVED
nyu Spanish consent with study data
 193

APPENDIX G

IRB APPROVAL
 Institutional Review Board

Veteran's Administration Hospital

Physical Address: 423 East 23rd Street | 10th Floor, West Wing | NY, NY 10010
Mailing Address: 5 5 0 1 * Avenue | WET 10* Floor, West Wing | NY, NY 10016
w
NYU School of Medicine

Continuation Review: Approved 9/25/2006

Differential Predictors of Psychological Well-being in a Latino/a Clinical Sample

Principal Investigator JDr. Carmen Vazquez Review Type E x p e d i t e d () 1
C o n t i n u a t i o n / A n n u a l Report
Submitted 05-Sep-2006
Phone (212) 263-6211 Email vazquc01@popmail.med.nyu.edu
IRB# 12785 Pert. Period 25-Sep-2006 - 24-Sep-2007
Location(s) Used B e l l e v u e H o s p i t a l
Review Date 25-Sep-2006 Board/Meeting Board A on 07-Nov-2006
Sponsor D e p a r t m e n t a l - Subjects 300 (total) 300 (approved)

The New York University School of Medicine's Institutional Review Board (IRB) is in receipt of your latest submission for the above-
referenced study. The submission was reviewed by the IRB on |25-Sep-2006| and the current IRB Status is: [Approved], The following
documents were approved for use in your study:

Protocol (nvd)
Informed Consent/Authorization version dated 7/14/05
Informed Consent/Authorization (Spanish) version dated 7/14/05

9/25/2006
R£lH#ll2785l
Elan Czeisler
Director, Institutional Review Board (IRB)
OHRP#FWA00004952

Notes:

1. You must submit all changes to this study (e.g., protocol, recruitment materials, consent forms, etc.) in writing to the IRB for review and
approval prior to initiation of the change(s), except where necessary to eliminate apparent immediate hazards to the subject(s). Changes made to
eliminate apparent immediate hazards to subjects must be reported to the IRB within 24 hours.
2. You must report all adverse and/or unanticipated event(s) that occur during the course of this study to IRB in writing in accordance with IRB Policy.
3. Use only iRB-approved copies of your consent form(s), questionnaire(s), letter(s), advertlsement(s), etc. in your study. Do not use expired consent
forms.
4. You must inform all research staff listed on this study of changes or adverse events which occur.
5. IRB's approval is valid until the end date of the performance period indicated above. A reminder for renewal should be e-mailed to you from the IRB 90,
60 and 30 days before this study's approval is scheduled to expire. However, you are responsible for submitting all renewal materials at least eight
weeks before expiration regardless of whether or not you receive a reminder notice.
6. All IRB policy documents can be found on our website: http://www.med.nvu.edu/irb/
7. Prior to initiating an IRB-approved study, you must receive written approval from an authorized representative for each site where your study will take
place. Key contacts are:
o NYU Hospital Center (Tlsch Hospital/Rusk Institute/Co-op Care) Irene Kreusher, VP, Tisch Hospital Administration. 212-263-2020
o Bellevue Hospital Mr. Anand Veereraj, Research Administrator, Bellevue Hospital Research Committee. 212-562-4176; Ms. Setira
Simmons, Research Administrator, Bellevue Hospital Research Committee. 212-562-7075
o GCRC (General Clinical Research Center) Hal Rosenblatt, Research Grants Coordinator. 212-263-7900; 212-263-8040
o VA Medical Center Administrator, R&D, Sub-committee for Human Studies. 212-686-7500 x7474
 o HJD (Hospital for Joint Diseases) Or. Paul Gusmorino, Liaison Coordinator, Institutional Board of Research Associates. 212-598-6368

The IBB may terminate studies that are not in compliance with NYU Medical Center/School of Medicine Policies & Procedures and the requirements of the
Institution's Federal Wide Assurance with the Federal Government. Direct IRB questions, correspondence and forms (e.g., continuing reviews, amendments,
adverse events, etc.) to phone 212-263-4110, fax 212-263-4147 or email IRB-info@med.nvu.edu.

New York University School of Medicine's Institutional Review Board

550 First Avenue | #VET 10th Floor, West Wing | New York, NY 10016
phone 212-263-41101 fax 212-263-41471 email IRB-info@med.nvu.edu | web http://www.med.nvu.edu/irb
The NYU SoM IRB operates in accordance with Good Clinical Practices (GCP) and applicable laws and regulations
APPENDIX H

ABSTRACT
Nerina Garcia

B.A., Leland Stanford Junior University

M.A., Fordham University

Differential Predictors of Subjective Well-being in a Latino/a Clinical Sample

Dissertation directed by John Cecero, Ph.D.

Given the dramatic changes in the United State's demographics, it is important to

understand culture's contribution to the therapeutic dyad. However, Latino/as continue

to be underrepresented in research. This study's objective was to expand the information

available on Latino/as, specifically whether certain personality traits (Neuroticism,

Extraversion, and Openness to Experience) from the Five Factor Model (FFM),

Psychological Mindedness (PM) and Acculturation predict Subjective Weil-Being

(SWB).

One hundred Clinical Latinos were recruited at a New York City public hospital

from outpatient clinics before their first therapy session, 77 were female. They were

administered three independent variable measures, the BFI (FFM), Psychological

Mindedness Scale and the AMAS-ZABB (U.S. and Latino competence composite

variable comprised of three subscales each), as well as demographic information. The

two dependent variable measures of SWB were the SOS-10-E and the PGWBS.

A hierarchical regression was conducted for each dependent measure (SOS-10-E

& PGWBS). First, a regression analysis was done regressing the dependent variable of

SWB on the independent variables of FFM (Neuroticism, Extraversion and Openness to

Experience), PM, the two dimensions of acculturation, and an interaction variable of the

two acculturation competence dimensions. The first step controlled for the demographic
variable, number of years in U.S., the independent variables were each entered as

separate steps. The change in R-square between each step revealed that the stable FFM

traits of Neuroticism and Openness to Experience predict SWB, with PM contributing

beyond the effect of the FFM. Acculturation did not significantly predicted SWB. A

step-wise regression evaluated the contribution the AMAS-ZABB Acculturation

subscales might have upon SWB, upon examination of the beta weights only the Latino

Language competence subscale significantly contributed to the prediction of SWB.

These findings indicate that low Neuroticism, high Openness to Experience, and

high Psychological Mindedness predict higher SWB among a Clinical Latino sample.

Being competent in Spanish might provide a protective effect against distress, but failed

to provide support for a significant effect of biculturalism predicting SWB. Clinical

implications and directions for future research are discussed.

APPENDIX I

VITA
 VITA

Nerina Garcia, daughter of Luis Jose and Simona Garcia, was born on July 21,

1975, in Los Angeles, California. She attended Pioneer High School in Whittier,

California, and was graduated in June, 1993.

She entered Stanford University in September, 1993 and received the degree of

Bachelor of Arts in Psychology and a Minor in Women's History in June, 1997.

In September, 2000 she was accepted as a graduate student in the Graduate

School of Arts and Sciences of Fordham University, where she majored in Clinical

Psychology under the mentorship of Professor John Cecero, Ph.D. At Fordham, she was

awarded a Presidential Tuition Scholarship, a Teaching Fellowship and a Senior

Teaching Fellowship.

While at Fordham, she received clinical training at New York University-

Bellevue Hospital Center's Bilingual Treatment Center, North Central Bronx Hospital,

and Jacobi Medical Center. She conducted research at Terence Cardinal Cooke

HIV/AIDS Convalescent Unit, Beth Israel Hospital and Montefiore Medical Center.