Objective: The objective of this study is to illuminate the need for reducing disparities related to stress and depression among Mexican American children.
Design: This study is a secondary data analysis of baseline data from a clinical trial designed to promote mental health and family functioning of Mexican American families.
Population, Sample, Setting, Years: The population of this study is children of immigrant Mexican women enrolled in the Rush Mexican American Problem Solving program. The sample consists of 47 fourth and fifth grade boys and girls. The settings for the study are two Chicago neighborhoods with one neighborhood being 98% Hispanic with most residents identifying themselves as Mexican American and the other characterized as international with 27-32 languages other than English designated as primary languages at the study schools. Data were collected in Fall, 2001.
Concepts of interest: The study is framed by the Mexican American Problem Solving Model, a derivation of the Interaction Model of Client Health Behavior (Cox, 1982). The concepts reported in this study are stress and depression as measured by the Spanish and English versions of the Stress Index (SI) and Child Depression Inventory (CDI). The Stress Index is a 14 item self-rated scale, consisting of 3 domains: Circumscribed Events, Life Transitions, and Exposure to Violence (Attar, Guerra, & Tolan, 1994). The Alpha co-efficient for the SI in this sample was 0.68. The Child Depression Inventory is a 27 item self-rated scale for children and is based on the Beck Depression Inventory (Kovacs, 11985). The Alpha co-efficient for the CDI in this sample is 0.74. Concern has been expressed about the cultural sensitivity of stress and depression screening tools. Focus groups with Hispanic professionals and interviews with Mexican immigrant mothers revealed however, that stress experiences and depression symptoms identified by the measures are consistent with experiences and beliefs among Hispanics.
Methods: Data were collected on home visits. Data collectors read the surveys with the children to address variability in reading levels. Children could choose English or Spanish. For this study, descriptive, correlational statistical analyses were utilized to describe experiences.
Findings: The mean SI score was 4.6, SD 2.7. While the mean stress score for this sample is not alarming, the stresses reported are. Specifically, 55% reported that a family member became seriously ill or was injured, 21% reported that a family member had been robbed or attacked. Nearly a third (32%) reported that they knew a person (other than a family member) who had been beaten, attacked or hurt and 21% reported they had seen or been around people shooting guns. More than half of the children (62%) reported that they were afraid to go outside to play or had been made to stay inside because of neighborhood danger while 47% had to hide some place because of neighborhood shootings. The mean CDI score was 8.54, SD 4.98. By comparison, Kline et al (1982) reported clinic and diverse public school mean scores of 11.2 (SD 6.8) and 8.54 (SD 7.6) respectively. With a cut score of 12 or greater, 28% of the study children required a referral for further mental health screening. Theoretically, self esteem and depression are correlated and the correlation is demonstrated in this sample (r=-.387, p=.007). Individual item responses on the CDI illustrate concerns among the children. Specifically, 68% worry or are sure that bad or terrible things will happen to them and 45% think about killing themselves. Many children (39%) are concerned that things will not work out for them. Nearly half of the children (45%) report inability or difficulty making decisions and 40% report that they have to push themselves to complete their school work. Nearly one quarter (23%) of the children have trouble sleeping at night. Over half (51%) of children worry about their aches and pains.
Conclusions: While the stresses that all children experience can impact adjustment, the high rates of violence exposure are highlighted as contributors to health disparities among Mexican American children. The Surgeon General’s report (2000) alerting the Nation to the epidemic of mental health problems is particularly validated by the high rate of depression symptoms among these Hispanic children.
Implications: A thorough analysis of the items reflecting children’s stresses and mental health provides insights for empirically based interventions. These startling findings underscore the significance of school based intervention research that will promote adaptation and reduce mental health symptoms of Mexican American children.
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