Acculturation, Internalizing Symptoms, and Self-Esteem 1 Running head: ACCULTURATION, INTERNALIZING SYMPTOMS, AND SELF-ESTEEM Acculturation, Internalizing Mental Health Symptoms, and Self-Esteem: Cultural Experiences of Latino Adolescents in North Carolina Paul R. Smokowski, Ph.D. University of North Carolina at Chapel Hill Martica L. Bacallao, M.S.S.W., Ph.D. University of North Carolina - Greensboro KEY WORDS: Latinos, Adolescents, Acculturation, Internalizing Problems, Self-Esteem We wish to thank the Latino families who participated in this study. This study was supported by grants from the United States Centers for Disease Control’s National Center for Injury Prevention and Control (R49/CCR42172-02) and from the Centers for Disease Control’s Office of the Director (1K01 CE000496-01). Address correspondence to the first author at the School of Social Work, University of North Carolina at Chapel Hill, 301 Pittsboro Street, CB 3550, Chapel Hill, NC 27599-3550 or email smokowsk@email.unc.edu Acculturation, Internalizing Symptoms, and Self-Esteem Acculturation, Internalizing Mental Health Symptoms, and Self-Esteem: Cultural Experiences of Latino Adolescents in North Carolina Abstract This investigation examined acculturation risk factors and cultural assets, internalizing behavioral problems, and self-esteem in 323 Latino adolescents living in North Carolina. Multiple regression analyses revealed two risk factors—perceived discrimination and parentadolescent conflict—as highly significant predictors of adolescent internalizing problems and low self-esteem. Adolescents who were highly involved in Latino culture and who experienced high parent-adolescent conflict were found particularly at risk for internalizing problems. Biculturalism and familism were cultural assets found associated with fewer internalizing problems and higher self-esteem. For internalizing problems, familism’s protective effect was mediated by parent-adolescent conflict. Implications were discussed. KEY WORDS: Latinos, Adolescents, Acculturation, Internalizing Problems, Self-Esteem 2 Acculturation, Internalizing Symptoms, and Self-Esteem 3 Introduction Latinos are currently the largest minority group and the fastest growing sociodemographic group in the United States1,2. In 2000, the United States Census Bureau counted more than 35 million Latinos, comprising 12.5% of the adult population and 15% of individuals under age 203. The fast pace of Latino immigration to the United States is shifting the nation’s age demographic because Latinos are more likely than non-Latinos to be under 18 years of age. In 2002, more than one-third of Latinos were under age 18 as compared to less than onequarter of the non-Latino White population4. Considering the fact that 40% of the Latino population in the United States is foreign born and 52% of this foreign-born group entered the country between 1990 and 20024, it is clear that many Latino youths are adjusting to life in a new culture and in a new country. Yet, we know little about how immigration and acculturation influences this fast-growing group of minority youths5. Much of the existing empirical research examining acculturation and mental health symptoms has serious limitations because the studies were skewed toward adults, low socioeconomic status, urban Latinos, and provided limited generalizable information 6,7,8. Further, most studies have used simple markers, such as language use or generational status, to index complex acculturation processes 9,6,8. In contrast, the current study addresses these issues by investigating acculturation risk factors, cultural assets, internalizing symptoms, and selfesteem in a sample of Latino youths in metropolitan, small town, and rural areas of North Carolina. Adolescent participants came from a range of socioeconomic backgrounds and represented a variety of Latino subgroups. Acculturation was measured and modeled as a multidimensional phenomenon using multiple scales. This investigation’s overarching goal was Acculturation, Internalizing Symptoms, and Self-Esteem 4 to examine how different dimensions of acculturation (e.g. culture-of-origin involvement, U.S. cultural involvement, and biculturalism) influence self-esteem and internalizing symptoms in Latino adolescents. Background Literature Acculturation Risk Factors Acculturation is a macro-level process in which cultural change results from contact between two autonomous cultural groups10. Usually, the non-dominant group is strongly influenced to take on the norms, values, and behaviors espoused by the dominant group 11. Assimilation, adopting host culture norms, values, and behaviors, has traditionally been seen as the end point to this process. An individual has become assimilated when she or he has given up culture-of-origin identity and established a positive identity with the dominant culture. Yet, over the past four decades, researchers have suggested that the goal of assimilation for new immigrants may be problematic and have increasingly included examinations of enculturation, or culture-of-origin affiliation, and bicultural identity development instead of, or along with, assimilation12,11,13. Assimilation and Acculturation Stress as Risk Factors Many acculturation researchers have hypothesized assimilation as a risk factor for social maladjustment, psychopathology, and substance use, suggesting that increasing levels of assimilation are associated with negative health behaviors and mental health difficulties14, 15,16,17,18. However, the few studies that have examined the association between assimilation and internalizing symptoms for Latino adolescents have produced mixed results8. Two investigations with Mexican American adolescents have shown one-fourth to one-third of the sampled youth reported serious levels of depression and suicidal ideation19, 20. National data from the U.S. Centers for Disease Control Acculturation, Internalizing Symptoms, and Self-Esteem 5 also indicate that, relative to other ethnic and racial groups, Latino adolescents are at heightened risk for depression and suicidal ideation21. Although neither of the empirical studies conducted to date found a relation between their assimilation measures and self-reports of depression, both studies found that acculturation stress was positively related to depression and suicidal ideation. One study identified perceived family dysfunction and negative expectations for the future as significant predictors of both acculturation stress and depression19. Other studies have identified language conflicts and racial discrimination as significant acculturation stressors. In a study of 5,264 multiethnic Latino high school students, Rumbaut 22 concluded that English-language competence was associated with lower rates of depression. Romero and Roberts23 compared stressors related to living in a bicultural context for both U.S.born and immigrant youth. Lower self-esteem and higher numbers of stressors, including various types of discrimination, predicted depressive symptoms. In addition, another investigation24 found a significant correlation between acculturation conflicts and self-derogation in a sample of 1,843 Cuban adolescents. This research revealed that problems inherent in the acculturation process were associated with lower self-esteem. Finally, Rasmussen and colleagues 25 showed that, even when controlling for depression and self-esteem, higher assimilation scores measured by the Acculturation Rating Scale for Mexican Americans were related to suicidal ideation in their sample of 242 Mexican American eighth graders. Parent-adolescent conflicts Normative conflicts between parents and adolescents may be exacerbated by acculturation stress, creating intercultural as well as intergenerational difficulties36,18. Children commonly become involved in the U.S. culture faster than adults, creating an “acculturation gap” between generations that is thought to foster parent-adolescent Acculturation, Internalizing Symptoms, and Self-Esteem conflict. 6 This cultural gap can result in alienation between parents and adolescents and may fuel adolescent rebellion36,18. Cultural Assets and Protective Factors Enculturation A growing movement within acculturation research emphasizes the appraisal of enculturation, or culture-of-origin identity, independent of assimilation or acculturation26. Enculturation, similar to other terms such as ethnic identity, culture-of-origin identity, or “Hispanicism”, denotes the individual’s feelings about and investment in their native culture; whereas, the term assimilation is used to refer to the individual’s investment or involvement in the host or adopted culture. Enculturation researchers consider three key aspects of ethnic identity: (a) cultural norms and values; (b) the strength, salience, and meaning of ethnic identity; and (c) the experience and attitudes associated with minority status27. Although enculturation or ethnic identity is often considered as an independent factor, it has also been considered in combination with host-culture identity to form a bicultural perspective13,27. Researchers have consistently found a positive relationship between ethnic identity and self-esteem8,17,28,29. One investigation with 669 Latino, African American, and White U.S.-born high school students identified ethnic identity as a cultural asset predicting higher self-esteem in all three ethnic groups28. In contrast, assimilation, in the form of host culture (i.e., U.S.) identity, only predicted self-esteem for White adolescents. Bat-Chava and Steen30 further confirmed this association in a meta-analysis that showed ethnic identity to have a moderately strong, positive relationship with self-esteem across ethnicities, gender, and age groups. Biculturalism Few investigations have evaluated the influence of integrating assimilation and enculturation to form bicultural involvement8,13,6. Most initial evidence indicates that biculturalism is associated with greater self-esteem, stronger social skills to interact with diverse Acculturation, Internalizing Symptoms, and Self-Esteem 7 groups, and heightened psychological well-being31,13. Investigations with immigrant adolescents have reported trends relating biculturalism to positive self-perceptions of global self-worth 32, and found bicultural youth to have the lowest levels of acculturation stress and to be less likely than either low- or high-assimilated Latino youth to report low family pride16. In addition, a study using census data to examine the link between biculturalism and school incompletion in more than 16,000 Mexican youths found bicultural youths less likely to drop out of school than either limited-English or English-only speakers33. Moreover, other investigators have shown that, as compared to low- and high-assimilated families, bicultural families displayed significantly lower levels of conflict and demonstrated more commitment, help, and support among family members34. However, not all studies support biculturalism as a cultural asset, and at least one study has reported that bicultural identity was not related to self-esteem, social competence, or academic performance35. Although most investigations show that biculturalism may be a promising cultural asset, clearly further research is needed to fully illuminate its effects. Familism is a deeply ingrained sense of being rooted in the family. The term refers to “attitudes, behaviors, and family structures within an extended family system and is believed to be the most important factor influencing the lives of Latinos” (p. 130)40. This strong sense of family orientation, obligation, and cohesion has noteworthy salutary effects41. For example, Cooley40 found familism to be an important deterrent to child maltreatment in both Latino and non-Latino families. Gil, Wagner, and Vega1 reported familism to have a statistically significant, negative association with acculturation stress. Familism is thought to decrease as acculturation progresses. Gil, Vega, and Dimas16 examined acculturation and adjustment in 6,670 middle school students in Dade County, Florida. They found that perceived intergenerational acculturation gaps between parents and children Acculturation, Internalizing Symptoms, and Self-Esteem increased with higher levels of U.S. cultural involvement. Both foreign-born and U.S.-born students with high U.S. cultural involvement were equally likely to report low family pride. Among foreign-born students, high U.S. cultural involvement dramatically decreased family pride or familism. Friendship networks Although social support from friends has been extensively studied as a health promoting asset for all ethnic and racial groups, little is known about the impact friendships have during the acculturation process. Friendships may be salient in lowering internalizing symptoms and enhancing self-esteem during the acculturation process because immigrant adolescents left their established social networks in their countries-of-origin. They must form new friendships while acculturating despite language barriers and discriminatory experiences. If prosocial friendships are not forged, adolescents would likely remain isolated or turn to antisocial peers for support. Summary and Hypotheses Extant studies indicate that certain aspects of assimilation and especially acculturation stressors are associated with depression, lower self-esteem, and suicidal ideation among Latino youth. At the same time, it is clear that further research is needed to examine how particular acculturation risk factors and cultural assets influence internalizing problems and self-esteem. Past studies of adolescent acculturation have focused primarily on delinquency and substance use, leaving us with a paucity of information on internalizing symptoms 8. Although substantial research has positively linked enculturation and ethnic identity to self-esteem, much less is known about its association with internalizing problems. Similarly, emerging evidence suggests that biculturalism is related to self-esteem and psychological well- 8 Acculturation, Internalizing Symptoms, and Self-Esteem 9 being. Both ethnic identity and biculturalism appear to be cultural assets, however, few studies have examined their impact on internalizing problems. The current study addresses these issues by investigating the relationships among acculturation risk factors and cultural assets—including assimilation, enculturation, and biculturalism—and internalizing symptoms and self-esteem in a sample of Latino youths living in metropolitan, small town, and rural areas of North Carolina. Adolescent acculturation was measured and modeled as a multidimensional phenomenon using multiple scales of Latino, nonLatino, and total cultural involvement. Based on past research, we made the following hypotheses: (a) assimilation and acculturation stressors, such as discrimination and parentadolescent conflicts, would be positively related to internalizing problems and negatively related to self-esteem, and (b) enculturation or culture-of-origin involvement, biculturalism, and prosocial friendships would be negatively related to internalizing problems and positively related to self-esteem. We also examined exploratory mediation and moderation effects between acculturation risk factors and cultural assets as preliminary steps for future research. Methods Procedure This investigation was part of the Latino Acculturation and Health Project, a longitudinal investigation of acculturation in Latino families in North Carolina and Arizona. Interviews were conducted with Latino adolescents and at least one of their parents. Active consent to participate was obtained from parents and adolescents before the interviews took place. All interviews were conducted in participants’ homes, using the participants’ preferred language. Interviewers were bilingual or bicultural graduate students in social work or public health. Our analyses focused on the acculturation process defined by multiple measures of acculturation—length of residence in Acculturation, Internalizing Symptoms, and Self-Esteem 10 the United States, Latino and non-Latino cultural involvement, and biculturalism. Acculturation stressors, such as perceived discrimination experiences and parent-child conflict, were also central concerns. The effects of these factors on adolescent self-reports of internalizing problems and self-esteem were analyzed using cross-sectional data. Community-based sampling was accomplished by recruiting participants at community events, as well as receiving referrals from Latino adolescents, English as a Second Language teachers, and social service and juvenile justice agencies. In the later part of data collection, interviewers specifically tried to recruit adolescents who were at higher risk for problematic behaviors. This targeted sampling of Latino adolescents was done to maximize the range of risk levels in the sample. Participants The sample was comprised of 323 Latino adolescents, of which 97% were born outside of the United States. The average age of the sampled youth was 15 years (SD=1.8; minimum = 11, maximum = 19), and slightly more than half (51%) of the sample was female. The average length of U.S. residency was 4.77 years with a range of 1 month to 17 years. Ninety-six percent of the adolescents attended school and the median grade was ninth grade. Sixty-six percent of the families who participated were from Mexico, 13% were from Central America, and 21% were from South America. Two-thirds of the adolescents lived with two parents, 24% lived with a single parent, and the remainder lived with other relatives or on their own. The average annual household income reported by participants’ parents was $22,446; the median was $19,000 (SD=11,772, minimum = $5,664 per year, maximum = $90,000), indicating that the sample represented families from an array of income levels but was primarily economically disadvantaged. Considering that the average family contained five people in the household, most Acculturation, Internalizing Symptoms, and Self-Esteem of the families in the sample were close to the federal poverty level. 11 Sixty-seven percent of participants’ parents had not graduated from high school and 45% of parents had less than a seventh-grade education. Independent Variables Analyses of the adolescent sample were conducted using measures of the following independent variables: gender, age, the amount of time the adolescent has lived in the United States, involvement in Latino and non-Latino cultures, biculturalism, perceived discrimination, familism, and parent-child conflict. 1. Gender was a dichotomous variable with females coded 1 and males coded 0. 2. Age is the adolescent’s age measured in years. 3. Involvement in Latino and non-Latino cultures was measured using the Bicultural Involvement Questionnaire (BIQ)36. The BIQ has 33 items measuring language, food, recreation, and media use on a 5-point Likert scale and has acceptable psychometric qualities 36. Instead of utilizing Latino-to-Anglo scale anchors used by many acculturation instruments, the BIQ scales separates questions into Latino and non-Latino categories; Likert anchors range from not at all to very much. Two subscales measure (a) involvement in Latino culture (sometimes called enculturation or “Hispanicism”), and (b) involvement in the host culture (sometimes called assimilation or “Americanism"”). Internal consistency reliability was reported as .79 for the entire BIQ, .93 for the Latino subscale, and .89 for the non-Latino subscale 36. Test-retest reliability over six weeks was reported to be .50 for Hispanicism, .54 for Americanism, and .79 for the entire BIQ (e.g. Biculturalism total score). In our sample of 323 Latino adolescents, internal consistency reliability was .78 for the entire BIQ, .89 for the Latino involvement subscale, and .91 for the non-Latino involvement subscale. Acculturation, Internalizing Symptoms, and Self-Esteem 12 4. Biculturalism was a calculation of total cultural involvement derived by combining the scores of the two subscales described above (i.e., Latino cultural involvement and non-Latino cultural involvement). Internal consistency reliability was .78 for the biculturalism scale in our sample. These analyses used the average scores for Latino cultural involvement, non-Latino cultural involvement, and biculturalism, calculated by first adding the items and then dividing by the number of items answered. This strategy minimizes missing data and results in final variables with the same possible ranges as the original 5-point Likert scale. 5. Perceived discrimination was a 3-item scale 24 measured on a five-point scale ranging from not at all to frequently. The utility of this scale has been well established in prior acculturation research 24,37,38,39. In prior studies, the internal consistency reliability was reported to be .56 24. In our sample, the internal consistency reliability was .74. 6. Familism, as defined for the purposes of this paper, is a deeply ingrained sense of being rooted in the family and a sense of solidarity with the family in which individual identity is inseparable from family identity 40. Moreover, familism engenders a strong sense of family orientation, obligation, and cohesion, with noteworthy salutary effects 41. Familism was assessed using six items1 scored on a 5-point Likert scale with responses ranging between strongly agree to strongly disagree. The items examined feelings of trust, confidence, loyalty, pride, and expression of emotions in the family. Developers of the familism scale reported internal consistency reliability to be .87; in this sample, the internal consistency reliability was .90. 7. Parent-adolescent conflict was assessed using the Conflict Behavior Questionnaire-20 (CBQ-20)42. This scale provides an overall measure of negative communication conflict within a parent-adolescent dyad. The CBQ-20 has 20 items that use a yes-no response format to assess positive and negative interactive behaviors in argumentative exchanges as well as exchanges Acculturation, Internalizing Symptoms, and Self-Esteem 13 lacking a conflict. Although reliability, validity, and minority-group norms have not been published for this CBQ-20 short form, researchers report that this instrument distinguishes distressed from non-distressed families43. The internal consistency reliability for the Conflict Behavior Questionnaire-20 in this sample was .89. 9. The Prosocial Friends Scale 44 consists of 10 items in a true or false format. This scale was developed as a part of the School Success Profile, a widely used instrument that assesses risk and protective factors in middle and high school settings. The range of scores is 0 to 10, with a higher score signifying relationships with more prosocial friends. The scale reliability for this sample was .67. Dependent Measures The first dependent measure assessed internalizing problems and was collected from adolescents using the Youth Self-Report (YSR)45. The YSR internalizing scale consists of three subscales: Anxious/depressed, Withdrawn/depressed, and Somatic complaints. Scores from these subscales were added together to create an internalizing scale score. The Anxious/depressed, Withdrawn/depressed, and Somatic complaints subscales consist of 13 items, eight items, and three items respectively, measured using a 3-point Likert scale (less than average, average, more than average). When combined to create the YSR internalizing scale, the score ranges from 0 to 48, with a higher score indicating a higher number of, and greater severity of internalizing problems. Prior studies reported the YSR internalizing subscale to have internal consistency reliability over .90 and test-retest reliability of .8045. The YSR has been used with Latino adolescents38. In our sample, the YSR internalizing scale reliability was .85. The second dependent measure was the Rosenberg Self-Esteem Scale (SES)46, which is widely used in social science research. We retained seven of the scale’s original 10 items, and Acculturation, Internalizing Symptoms, and Self-Esteem 14 scored on a 4-point scale ranging from strongly agree to strongly disagree. Possible scores ranged from 7 to 28. For this data set, the calculated reliability of the seven-item Rosenberg SES was .83. Reliability from prior studies cannot be compared because we dropped items. The three items we deleted were I wish I could have more respect for myself, At times, I think I am no good at all, and I am able to do things as well as most other people. We chose to drop these items because they did not have significant factor loadings when factor analyses were conducted, and scale reliability was enhanced when they were deleted. We believe these items were problematic because they did not have straightforward translations from English to Spanish. Further, the meaning of these items was complicated for disadvantaged immigrants who experienced daily discrimination. It was unclear whether these particular items would measure low self-esteem or form a realistic appraisal of participants’ low status in U.S. society. Data Analyses Following our examination of bivariate correlations, independent variables were entered into OLS linear regression models in hierarchical single-variable blocks. Demographic variables were entered first (e.g., gender, age); followed by acculturation variables (e.g., length of time the adolescent has lived in the United States, adolescent involvement in Latino culture, involvement in non-Latino culture, adolescent biculturalism, and perceived discrimination); family attributes (e.g., familism, parent-child conflict); and finishing with the prosocial friends scale. This approach allowed for examination of mediation processes in the data47,48. We chose this order of entry to examine if family attributes mediated acculturation variables. Using the approach suggested by Baron and Kenny48, mediation effects were identified for variables that were significant upon initial entry into the model, but became non-significant when a subsequent variable was entered into the model. The decomposition of mediation effects Acculturation, Internalizing Symptoms, and Self-Esteem 15 and significance testing for the indirect effect was performed using the seminal methods of Alwin and Hauser47. The direct effect was the variable’s standardized coefficient when the mediator was in the model. The total effect was the coefficient without the mediator. The indirect effect was obtained by subtracting the direct effect from the total effect. The difference between the model F-statistics with and without the mediator provided a test statistic for the indirect effect with the number of degrees of freedom equal to the number of variables subtracted from the total model—usually one for the mediator. Acculturation measures, especially Latino cultural involvement, non-Latino cultural involvement, and biculturalism (total cultural involvement) display significant intercorrelations. These variables were not used in the same model to avoid multicollinearity. In order to independently evaluate the relative predictive values of Latino cultural involvement, non-Latino cultural involvement, and biculturalism, three models were tested for each dependent variable. The first model, Ethnic Identity, tested adolescent Latino cultural involvement. The second model, U.S. Identity, included adolescent non-Latino (U.S.) cultural involvement. The final model, Biculturalism, examined adolescent total cultural involvement. Systematically testing the cultural involvement scales in this way allowed us to compare main effects and determine which subscale was responsible for biculturalism effects. Along with direct and mediation effects, moderation effects were assessed by entering interaction terms in the regression models. Interactions between adolescent Latino cultural involvement, adolescent non-Latino cultural involvement, and adolescent biculturalism and parent-child conflict, familism, and discrimination were entered into the regression models (e.g., biculturalism x parent-child conflict, biculturalism x discrimination, biculturalism x familism). Acculturation, Internalizing Symptoms, and Self-Esteem 16 Because interaction terms can introduce problematic levels of multicollinearity into regression equations, creating high variance inflation factors and low tolerances, all of the continuous variables were centered by taking the difference between observed scores and the grand mean before calculating interaction terms49,50. This procedure lowered collinearity, rendering acceptable variance inflation factors and tolerance diagnostics. For parsimony, only significant independent variables and interaction terms were retained in the final regression models. Results Table 1 shows bivariate correlations between all independent and dependent variables. Standardized regression coefficients and R2 change statistics from hierarchical multiple regression models for internalizing symptoms and self-esteem are shown in Table 2. Independent variables were entered individually into linear regression models in the ecological order shown in the tables. Direct, indirect, and total effects were decomposed in Table 3. ********************************* Insert Tables 1, 2, and 3 about here ********************************* Hypothesis I: Assimilation and acculturation stressors, such as discrimination and parentadolescent conflicts, are positively related to internalizing problems and negatively related to self-esteem. This hypothesis was partially supported. Assimilation as indicated by length of U.S. residency was not significantly related to internalizing problems, but significantly predicted lower levels of self-esteem. At the same time another measure of assimilation, adolescent involvement in non-Latino (U.S.) culture, was shown as negatively associated with internalizing symptoms and not significantly related to self-esteem, contradicting Hypothesis I. Further, adolescent involvement in non-Latino (U.S.) culture served as a protective factor by moderating Acculturation, Internalizing Symptoms, and Self-Esteem 17 the impact of parent-adolescent conflict on internalizing symptoms (see the interaction term in Table 2 for the U.S. identity model). Acculturation stressors were deleterious, lending support to Hypothesis I. Parentadolescent conflict explained the largest portion of the variance in internalizing symptoms, but was not related to self-esteem. Perceived discrimination was another significant stressor positively associated with internalizing problems. For self-esteem, the direct effect of perceived discrimination was mediated by familism and prosocial friends (see Table 3). Hypothesis II: Culture-of-origin involvement (e.g., enculturation), familism, prosocial friends, and biculturalism would be negatively related to internalizing problems and positively related to self-esteem. There was also partial support for Hypothesis II. Adolescent involvement in Latino culture was not significantly related to internalizing problems until the interaction term between involvement in Latino culture and parent-adolescent conflict was entered into the model. Although the Beta coefficient for adolescent involvement in Latino culture became significant when the interaction term was in the model, this should be interpreted cautiously because, on its own, this variable did not explain a significant amount of variance in internalizing symptoms. Adolescent involvement in Latino culture was associated with higher self-esteem; however, this direct effect was mediated by familism (see Tables 2 and 3). Familism was the strongest factor associated with self-esteem. However, in all three models predicting internalizing symptoms, the Beta coefficient for familism was not significant when parent-adolescent conflict was entered into the model, signaling a mediation effect. As hypothesized, prosocial friends were associated with higher self-esteem; however, friends had no relationship with internalizing symptoms. Acculturation, Internalizing Symptoms, and Self-Esteem 18 Our hypothesis was also supported for biculturalism, which displayed statistically significant relationships with internalizing problems and self-esteem, both in the hypothesized direction. Because the biculturalism score was created by adding the Latino and non-Latino involvement scores, the different cultural models suggested that the biculturalism effect associated with internalizing symptoms is driven by non-Latino cultural involvement while the effect for self-esteem was likely attributable to Latino cultural involvement. However, for both outcomes, it is important to note that the amount of variance explained by biculturalism is larger than the amount explained by either of its constituent subscales. Exploratory mediation and moderation effects between acculturation risk factors and assets Mediation effects As noted above, direct, indirect, and total effects were decomposed in Table 3. We found two statistically significant mediating effects in the internalizing symptoms models: Perceived discrimination was mediated by familism, and parent-adolescent conflict mediated familism. Seventy-seven percent of the effect of familism on internalizing problems was mediated by parent-child conflict and 43% of the effect of discrimination on internalizing problems was mediated by familism in the U.S. Identity model. Forty-three percent of the effect of Latino cultural involvement on self-esteem was mediated by familism. Seventy-three percent of the effect of perceived discrimination on selfesteem was mediated by prosocial friends in the Ethnic Identity model and 57% of the perceived discrimination effect was mediated by familism in the Biculturalism model. Moderation effects In the Ethnic Identity model for internalizing symptoms, the Latino cultural involvement x parent-adolescent conflict interaction term was highly statistically significant, making the Beta coefficient for adolescent Latino cultural involvement significant even though this variable, when examined on its own, did not explain a significant portion of the Acculturation, Internalizing Symptoms, and Self-Esteem 19 variance. The adolescent Latino involvement x parent-adolescent conflict interaction term’s positive Beta coefficient indicated that adolescents who reported both high Latino cultural involvement and high parent-adolescent conflict also reported the most internalizing symptoms. In the U.S. Identity model for internalizing symptoms, adolescent involvement in nonLatino culture was significant until the interaction effect was included in the model for adolescent non-Latino cultural involvement x parent-adolescent conflict. This interaction effect and the one described above, indicate the same essential finding: less-assimilated adolescents (e.g., those with higher Latino cultural involvement or lower non-Latino cultural involvement), coupled with high levels of parent-adolescent conflict, reported the highest rates of internalizing problems. Finally, there was a significant interaction effect for biculturalism x prosocial friends in predicting self-esteem. The negative sign in the slope coefficient suggested that although prosocial friends were associated with higher self-esteem in all sampled Latino adolescents, these friends were particularly important for less-bicultural adolescents. Discussion This investigation’s analyses broke new ground for acculturation research by comparing a simple, commonly used indicator of linear acculturation (e.g., length of U.S. residency), bidirectional acculturation scales (e.g., Latino and non-Latino cultural involvement), and acculturation stressors (e.g. discrimination, parent-adolescent conflict) in the same models. Responding to the directions for new research proposed in major reviews of acculturation research8,13,6, this study also examined biculturalism and its constituent cultural components. Parent-adolescent conflict was the dominant risk factor for internalizing problems. Not only was parent-adolescent conflict associated with more internalizing symptoms, but it also mediated the beneficial effect of familism on this outcome. These negative effects for parent- Acculturation, Internalizing Symptoms, and Self-Esteem 20 adolescent conflict support previous research findings that show family dysfunction to be predictive of acculturation stress and depression19. For the past quarter of a century, parent-adolescent conflict has been implicated for its association with serious problems in the acculturation process; however, little empirical data had been collected to support this assertion 8. The difficulties that arise from parent-adolescent conflicts have often been attributed to intergenerational “acculturation gaps” between parents and their children that result from the younger generation assimilating faster than the older generation 18. Although this is an intriguing clinical hypothesis, our empirical data painted a different picture. Parent-adolescent conflict demonstrated a strong direct effect predicting internalizing problems. Moreover, significant moderation effects between cultural involvement variables and parentadolescent conflict showed that the adolescents who reported the greatest internalizing problems were those who were both highly involved in Latino culture and in conflict with their parents. Relative to this group, adolescents who were more involved in non-Latino culture (e.g., more assimilated) had lower internalizing scores, making non-Latino cultural involvement a protective factor in the context of parent-adolescent conflict. Overall, these effects suggest that adolescents highly involved with Latino culture and less involved in non-Latino culture are at the highest risk of internalizing problems when parent-adolescent conflicts occur. Being in conflict with their Latino parents may trouble these youths more than their more assimilated counterparts because they are so invested in their ethnic identities and so familistic. In addition, it is possible that these low-assimilated youth do not have an outlet outside of their homes to reach out to for help during conflicts with their parents. During periods of high parent-adolescent conflict, this combined discomfort with family strife and lack of alternative outlets may leave adolescents highly involved in Latino culture feeling isolated and depressed. Acculturation, Internalizing Symptoms, and Self-Esteem 21 Perceived discrimination was another important acculturation risk factor that has not received the attention it deserves in the research literature. Supporting previous studies on acculturation stressors 19,20, we found perceived discrimination associated with higher levels of internalizing problems and lower self-esteem. Although this effect was mediated by prosocial friends and familism in the multivariate models for predicting self-esteem, it still explained a significant portion of self-esteem’s variability. These findings support previous work linking discrimination experiences to self-derogation24,37 and depression23 and extend this work by showing how discrimination can impact both positive and negative developmental outcomes. Experiencing discrimination is one of the most adverse elements in the acculturation process. It is commonly thought that negative health behaviors, such as alcohol and substance use, may be used as a strategy for coping with acculturation stress1. Maladaptive behavior is thought to derive from “increased perceptions of discrimination, internalization of minority status, and/or socialization into cultural attitudes and behaviors that have a disintegrative effect on family ties” (p. 45)16. This results in self-deprecation, ethnic self-hatred, and a weakened ego structure in the assimilated individual6. It is critical that future research examine the dynamics of discrimination experiences in greater detail. From an intervention and prevention standpoint, these findings raise additional questions as to how Latino parents and prosocial friends can help Latino adolescents understand and cope with discrimination. Our analyses also show that the impact of discrimination can be lessened by family and friends. Service providers should strive to promote open discussion of discriminatory experiences and coping methods among Latino adolescents, their families, and friends as a part of intervention and prevention programming51. Although acculturation stressors such as parent-adolescent conflict and perceived discrimination were clearly important, examination of cultural involvement scales lay at the heart Acculturation, Internalizing Symptoms, and Self-Esteem 22 of this investigation. Unlike previous research14,15,16,34, we found mixed evidence that high assimilation was a strong risk factor; the direction of the relationship depended upon the outcome of interest. Revealing one of the disadvantages of assimilation, longer U.S. residency was significantly associated with lower self-esteem. On the other hand, adolescent involvement in non-Latino culture was a protective factor associated with reporting fewer internalizing symptoms, especially in the context of parent-adolescent conflict. These contradictory findings show how complex and context-dependent acculturation processes are. For internalizing symptoms, adolescent Latino cultural involvement or ethnic identity was only significant in its interaction with parent-adolescent conflict, indicating that adolescents highly involved in Latino culture reported more internalizing symptoms when in conflict with their parents. Mirroring previous studies30,28,29, we found ethnic identity (defined as Latino cultural involvement) to have a significant, though modest, relationship with adolescent selfesteem. Unlike previous investigations, we contrasted this effect with mainstream U.S. identity (or non-Latino cultural involvement) and biculturalism and found biculturalism to have the strongest effect—just as alternation theorists have predicted33,16,8. Further, the positive Latino cultural involvement effect on self-esteem was mediated by familism. Latino cultural involvement and familism are two aspects of cultural life that are significantly correlated for Latinos. Future studies of enculturation and ethnic identity should include both to parse out their relative contributions in predicting important outcomes. Finally, and perhaps most importantly, we found that biculturalism was a robust cultural asset associated with both fewer internalizing problems and higher self-esteem. Compared to past investigations that used simple items on language use or time in the country, bi-dimensional cultural involvement measures captured more of the complexity of the acculturation process6,13. Acculturation, Internalizing Symptoms, and Self-Esteem 23 Consequently, the analyses showed that biculturalism was a cultural asset for different reasons. The biculturalism effect for internalizing problems appeared to be driven by the adolescents’ non-Latino cultural involvement while biculturalism’s positive effect on self-esteem was likely attributable to the maintenance of high levels of Latino cultural involvement. This complexity makes biculturalism a particularly intriguing asset worthy of further investigation. Our analytic strategy for modeling multiple components of cultural involvement provides future studies with a template for intensely examining acculturation dynamics. Implications for practice and policy It behooves social workers and psychologists to (a) pay more attention to the deleterious effects that parent-adolescent conflict and perceived discrimination have on Latino families, and (b) advocate for programs and policies that decrease familial conflict and reduce discrimination 51 . Discrimination resistance skills and family communication enhancement are viable intervention components that warrant further integration into practice. Taken together, these findings support the importance of working with Latino youth in a family context. Using a risk and protective factor framework for prevention intervention52, social workers and psychologists should attempt to decrease the impact of discrimination and parent-adolescent conflict while increasing the salutary influence of familism and biculturalism. Bicultural family skills training intervention packages have been available since the 1980’s; however, it appears that they need to be disseminated more rigorously to promote the adjustment of rapidly-acculturating families. Limitations The most serious limitation of this study is also one of its strengths. The unique sampling frame providing previously unknown information about acculturation processes in Latino families in North Carolina limited the investigation’s generalizability. Caution is warranted in Acculturation, Internalizing Symptoms, and Self-Esteem 24 applying the findings to Latinos beyond this geographical area. Although the range of Latino cultural subgroups represented roughly paralleled national proportions, the sample size for some of the subgroups was too small to conduct separate analyses by national origin. Similarly, only a small percentage (3%) of the adolescents in the sample were born in the United States, making separate analyses by nativity impossible. Although we hope that this study encourages more research on mediation and moderation processes in acculturation research, caution is warranted in interpreting the mediation effects. One rule for mediation is that the mediator should impact the dependent variable but the dependent variable should not be able to impact the mediator47,48. Using cross-sectional data, this rule may be difficult to satisfy. For example, the impact of familism on internalizing symptoms was mediated by parent-adolescent conflict; however, lacking longitudinal data, this study could not determine that parent-adolescent conflict led to adolescent internalizing problems rather than adolescent internalizing problems leading to parent-adolescent conflict. Future investigations of mediation pathways should include longitudinal data from multiple reporters. That work is currently underway as we collect multiple waves of data from Latino families in North Carolina and Arizona. Future studies from the Latino Acculturation and Health Project will address these limitations. Summary This investigation examined acculturation risk factors and assets, internalizing behavioral problems, and self-esteem in 323 Latino adolescents living in North Carolina. Although a wide range of families from different cultures-of-origin and socioeconomic strata were represented, the sample mainly consisted of disadvantaged, immigrant adolescents from Mexico. Multiple regression analyses revealed two risk factors—parent-adolescent conflict and perceived discrimination—as highly significant predictors of adolescent internalizing problems and low Acculturation, Internalizing Symptoms, and Self-Esteem 25 self-esteem. Parent-adolescent conflict was the dominant risk factor identified for internalizing problems, but was not found related to self-esteem. Not only was parent-adolescent conflict associated with more internalizing symptoms, but it also mediated the positive effect of familism on this outcome. Adolescents who were highly involved in Latino culture and also experienced high parent-adolescent conflict were found particularly at risk for internalizing problems. We found biculturalism and familism the cultural assets associated with fewer internalizing problems and higher self-esteem. Familism was by far the strongest predictor of Latino adolescent self-esteem. Although familism’s relationship with internalizing problems was mediated by parent-adolescent conflict, familism also mediated the effect of perceived discrimination on self-esteem and, to a lesser extent, on internalizing problems. Finally, the separate analyses of Latino and non-Latino cultural involvement and biculturalism showed that biculturalism was a cultural asset for different reasons. The biculturalism effect for internalizing problems appeared to be driven by the adolescents’ non-Latino cultural involvement while biculturalism’s positive effect on self-esteem seemed to be due to the maintenance of high levels of Latino cultural involvement. The complexity of biculturalism warrants further investigation. Practitioners and policy makers interested in the mental health and well-being of Latino adolescents should direct their efforts to helping decrease parent-adolescent conflict, and addressing institutional and interpersonal discrimination. At the same time, programs and policies should focus on helping Latino families maintain familism and develop bicultural competencies in order to reduce the potential for Latino adolescents to develop internalizing problems or low self-esteem. Future investigations should examine the complexity of the acculturation process by integrating multiple cultural involvement scales in the study protocol. Acculturation, Internalizing Symptoms, and Self-Esteem 26 References 1. Gil AG, Wagner EF, Vega WA. Acculturation, familism, and alcohol use among Latino adolescent males: Longitudinal relations. J Community Psychol. 28(4): 443-458, 2000. 2. United States Census Bureau. Facts on the Hispanic or Latino population. 2006. http://www.census.gov/pubinfo/www/NEWhispML1.html. 3. United States Census Bureau. United States Census Bureau interactive census database. 2001. http://www.census.gov. 4. Ramirez RR, de la Cruz GP. The Hispanic population in the United States: March 2002. [2003.] Available at: http://www.census.gov/prod/2003pubs/p20-545.pdf Accessed April 18, 2006 5. Suarez-Orozco C, Suarez-Orozco M. Children of Immigrants. Cambridge, Mass: Harvard University Press; 2001. 6. Rogler LH, Cortes RS, Malgady RG. Acculturation and mental health status among Hispanics. Am Psychol. 46: 585-597, 1991. 7. Balls-Organista PB, Organista KC, Kurasaki K. The relation between acculturation and ethnic minority mental health. In: Chun KM, Balls Organista P, Marin G, eds. Acculturation: Advances in Theory, Measurement, and Applied Research Washington DC: American Psychological Association; 139-161, 2003. 8. Gonzales NA, Knight GP, Morgan-Lopez A, Saenz D, Sirolli A. Acculturation and the mental health of Latino youths: An integration and critique of the literature. In: Contreras JM, Kerns KA, Neal-Barnett AM, eds. Latino Children and Families in the United States. Westport, CT: Greenwood; 45-74, 2002. 9. Cabassa LJ. Measuring acculturation: Where we are and where we need to go. Hispanic Journal of Behavioral Studies. 25: 127-146, 2003. 10. Redfield R, Linton R, Herskovits M. (1936). Memorandum for the study of acculturation. Am Anthropol. 38: 149-152, 1936. 11. Berry JW. Acculturation stress. In: Balls Organista P, Chun KM, Marin G, eds. Readings in Ethnic Psychology. New York, NY: Routledge; 117-122, 1998. 12. de Anda D. Bicultural socialization: Factors affecting the minority experience. Social Work. March-April:101-107, 1984. 13. LaFromboise T, Coleman HL, Gerton J. Psychological impact of biculturalism: Evidence and theory. Psychol Bull. 114: 395-412, 1993. Acculturation, Internalizing Symptoms, and Self-Esteem 27 14. Al-Issa I, Tousignant M, eds. Ethnicity, Immigration, and Psychopathology. New York, NY: Plenum Press; 1997. 15. Delgado M. Alcohol Use/Abuse Among Latinos: Issues and Examples of Culturally Competent Service. New York, NY: Haworth Press; 1998. 16. Gil AG, Vega WA, Dimas JM. Acculturative stress and personal adjustment among Hispanic adolescent boys. J Community Psychol. 22: 43-54,1994. 17. Martinez RO, Dukes RL. The effects of ethnic identity, ethnicity, and gender on adolescent well-being. J Youth Adolesc. 26: 503-516, 1997. 18. Szapocznik J, Kurtines WM. Acculturation, biculturalism and adjustment among Cuban Americans. In: Padilla A, ed. Acculturation: Theory, Models, and Some New Findings. Boulder, Colo: Praeger; 139-159, 1980. 19. Hovey JD, King CA. Acculturative stress, depression, and suicidal ideation among immigrant and second-generation Latino adolescents. J Am Acad Child Adolesc Psychiatry. 35: 1183-1192, 1996. 20. Katragadda CP, Tidwell R. (1998). Rural Hispanic adolescents at risk for depressive symptoms. J Appl Soc Psychol. 28: 1916-1930, 1998. 21. Centers for Disease Control and Prevention. (2004). Surveillance summaries, May 21, 2004, MMWR 2004:53(No. SS-2). 2004. 22. Rumbaut RG The new Californians: Comparative research findings on the educational progress of immigrant children. In: Rumbaut RG, Cornelius WA, eds. California’s Immigrant Children: Theory, Research, and Implications for Educational Policy. San Diego, Calif: Center for U.S.-Mexican Studies; 17-69, 1995. 23. Romero AJ, Roberts RE. Stress within a bicultural context for adolescents of Mexican descent. Cultur Divers Ethnic Minor Psychol. 9: 171-184, 2003. 24. Vega WA, Gil AG, Warheit G, Zimmerman R, Apospori E. Acculturation and delinquent behavior among Cuban American adolescents: Toward an empirical model. Am J Community Psychol. 21: 113-125, 1993. 25. Rasmussen KM, Negy C, Carlson R, Burns JM. Suicide ideation and acculturation among low socioeconomic status Mexican-American adolescents. Journ of Early Adol. 17(4): 390-407, 1997. 26. Gonzales N, Knight GP, Birman D, Sirolli A. Acculturation and enculturation among Latino youth. In: Maton K, Shellenbach C, Leadbetter BJ, Solarz AL, eds. Investing in Children, Youth, Families, and Communities: Strengths-Based Research and Policy Washington, DC: American Psychological Association; 285-302, 2004. Acculturation, Internalizing Symptoms, and Self-Esteem 28 27. Phinney JS. When we talk about American ethnic groups what do we mean? Am Psychol. 31: 918-927, 1996. 28. Phinney JS, Cantu CL, Kurtz DA. Ethnic and American identity as predictors of selfesteem among African-American, Latino, and White adolescents. J Youth Adolesc. 26: 165-185, 1997. 29. Phinney JS, Chavira V, Tate JD. Parental ethnic socialization and adolescent coping with problems related to ethnicity. J Res Adolesc. 5: 31-53, 1995. 30. Bat-Chava Y, Steen EM. Ethnic identity and self-esteem: A meta-analytic review. Unpublished manuscript cited in Gonzales NA, Knight GP, Morgan-Lopez A, Saenz D, Sirolli A. (2002). Acculturation and the mental health of Latino youths: An integration and critique of the literature. In: Contreras J, Neal-Barnett A, Kerns K, eds. Latino Children and Families in the United States: Current Research and Future Directions. Westport, Conn: Praeger; 45-74, 2000. 31. Bautista de Domanico Y, Crawford I, Wolfe AS. Ethnic identity and self-concept in Mexican-American adolescents: Is bicultural identity related to stress or better adjustment? Child & Youth Care Forum. 23: 197-206, 1994. 32. Birman D. Biculturalism and perceived competence of Latino immigrant adolescents. Am J Community Psychol. 26: 335-354, 1998. 33. Feliciano C. The benefits of biculturalism: Exposure to immigrant culture and dropping out of school among Asian and Latino youths. Soc Sci Q. 82: 865-879, 2001. 34. Miranda AO, Estrada D, Firpo-Jimenez M. Differences in family cohesion, adaptability, and environment among Latino families in dissimilar stages of acculturation. The Family Journal: Counseling and Therapy for Couples and Families. 8: 341-350, 2000. 35. Rotheram-Borus MJ. Adolescents’ reference-group choices, self-esteem, and adjustment. J Pers Soc Psychol. 59: 1075-1081, 1990. 36. Szapocznik J, Kurtines W, Fernandez T. Biculturalism involvement and adjustment in Hispanic-American youths. International Journal of Intercultural Relations. 4: 353-365, 1980. 37. Vega WA, Zimmerman R, Warheit G, Apospori E, Gil AG. Risk factors for early adolescent drug use in four ethnic and racial groups. Am J Public Health. 83: 185-189, 1993. 38. Vega WA, Zimmerman R, Khoury E, Gil AG, Warheit G. Cultural conflicts and problem behaviors of Latino adolescents in home and school environments. J Community Psychol. 23: 167-179, 1995. Acculturation, Internalizing Symptoms, and Self-Esteem 29 39. Vega WA, Kolody B, Aguilar-Gaxiola S, Alderete E, Catalano R, Caraveo-Anduaga J. Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Arch Gen Psychiatry. 55: 771-778, 1998. 40. Cooley C. The relationship between familism and child maltreatment in Latino and Anglo families. Child Maltreat. 6: 130-142, 2001. 41. Vega WA. The study of Latino families: A point of departure. In: Zambrana RE, ed. Understanding Latino Families: Scholarship, Policy, and Practice (pp. 3-17). Thousand Oaks, Calif: Sage; 3-17, 1995. 42. Robin AL, Foster SL. Negotiating Parent-Adolescent Conflict: A Behavioral-Family Systems Approach. New York, NY: The Guilford Press; 1989. 43. Rush AJ, Task Force for the Handbook of Psychiatric Measures Handbook of Psychiatric Measures. Washington, DC: American Psychiatric Association; 2000. 44. Bowen GL, Rose R, Bowen NK. The Reliability and Validity of the School Success Profile. Philadelphia, PA: Xlibris; 2005. 45. Achenbach TM. Manual for the Child Behavior Checklist 4-18 and 1991 profile. Burlington, Vt: University of Vermont; 1991. 46. Rosenberg M. Society and the Adolescent Self-Image. Revised Edition. Middletown, Conn: Wesleyan University Press; 1989. 47. Alwin DF, Hauser RM. The decomposition of effects in path analysis. Am Sociol Rev. 40: 37-47, 1975. 48. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. J Pers Soc Psychol. 51: 1173-1182, 1986. 49. Neter J, Kutner MH, Nachtsheim CJ, Wasserman W. Applied Linear Regression Models (3rd Ed.). Chicago, Ill: Irwin; 1996. 50. Tabachnick BG, Fidell LS. Using Multivariate Statistics (4th Ed.). Boston, Mass: Allyn and Bacon; 2001. 51. Bacallao ML, Smokowski PR. Entre dos mundos (Between two worlds): Bicultural skills training with Latino immigrant families. J Prim Prev. 26: 485-509, 2005. 52. Fraser MW, Kirby LD, Smokowski PR. Risk and resilience in childhood. In Fraser MW, ed. Risk and Resilience in Childhood: An Ecological Perspective (2nd Edition. Washington DC: National Association of Social Workers; 2004.