Date of Degree

6-2017

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor(s)

Tracey A. Revenson

Committee Members

Michael A. Hoyt

Ana F. Abraido-Lanza

Tyrel J. Starks

Regina Miranda

Vanessa L. Malcarne

Subject Categories

Health Psychology | Multicultural Psychology | Psychology

Keywords

Hispanic, Latino, Cancer, Coping, Culture, Familismo, Espiritu, Respeto, Adolescence, Young Adults

Abstract

Parental cancer has a strong influence on the psychological well-being of children at all ages. Children and adolescents whose parents have more distress and advanced disease tend to have lower rates of healthy psychological adjustment. Children from the U.S. Latino/a population may face additional challenges, such as racism and acculturative stress that compound the stress of having a parent with cancer. At the same time, facets of the Latino/a culture may play a crucial role in how Latino/a adolescents adapt to parental cancer, specifically the Latino/a cultural values of familismo (familism), espíritu (spirit), and respeto (respect).

This cross-sectional study examined the relation of Latino/a cultural values to coping and psychological adjustment among adolescents and young adults (AYAs). Specific aims were to examine: 1) the associations between AYA’s stress and coping responses and psychological adjustment to their mother’s cancer; 2) the direct and moderation effect of three Latino/a cultural values –familismo, espíritu, and respeto –on the coping-adjustment association; 3) the effects of age and gender on coping responses, cultural values, and psychological adjustment outcomes; and 4) the associations between severity of the parent’s cancer and the parent’s level of distress with AYA’s psychological adjustment.

The sample included 38 Latino/a AYAs who were coping with their mother’s breast cancer (n=24). AYAs and mothers completed questionnaires in English or Spanish in-person or by mail. A subsample of seven AYAs completed an optional interview. Psychological adjustment was measured by symptoms of depression (Center for Epidemiological Studies Depression Scale (CES-D; Eaton et al., 2004; Faulstich et al., 1986) and anxiety (adults: Generalized Anxiety Disorder scale; Spitzer et al., 2006; AYAs: Spence Children’s Generalized Anxiety Scale, Spence, 1998). Stress appraisals and coping responses were measured with six subscales from the Response to Stress Questionnaire (RSQ; Connor-Smith et al., 2000) and the religious subscale from the Brief COPE (Carver, 1997); Latino/a cultural values of familismo and respeto were measured with the Mexican-American Cultural Values Scale (MACVS; Knight et al., 2009); the espíritu value was measured with the Systems of Belief Inventory (SBI-15R; Holland et al., 1998).

Results demonstrated that stress appraisals and the coping responses of secondary control, disengagement, involuntary disengagement, and involuntary engagement coping were positively correlated with symptoms of depression and anxiety. The Latino/a cultural values of familismo and espíritu were associated, both directly and indirectly, with fewer symptoms of depression and anxiety. Higher endorsement of these values was associated with lower symptoms of depression and anxiety and greater primary control and religious coping use. Protective patterns of familismo and espíritu were evident in their interactions with coping responses. At higher levels of familismo, secondary control coping was negatively associated with symptoms of depression, but at lower levels of familismo, secondary control coping was positively associated with symptoms of depression. A similar pattern was also found for the espíritu value with both primary and secondary control coping. However, this buffering effect was less evident for involuntary modes of coping (disengagement and involuntary disengagement coping). AYAs whose mother was in active treatment had greater anxiety. Age, gender, severity of mother’s cancer and mother’s distress were unrelated to coping or adjustment outcomes.

The findings suggest that Latino/a AYAs experience significant distress, but those with higher levels of familismo and espíritu may fare better than those with lower levels of these values. The creation of psychosocial interventions for Latino/a AYAs should incorporate or strengthen Latino/a values, however, these culturally tailored interventions need to be based on needs assessments of Latino/a AYAs and their families, and their communities.

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