Facilitators and Barriers to Shared Decision-Making Communication Between Latina Mothers and Pediatric Mental Healthcare Providers.

This study assessed communication factors influencing shared decision-making (SDM) between language-congruent clinicians and Latina mothers of pediatric mental health patients. The sample comprised Latinx youth up to 22 years old who were enrolled in mental healthcare and attended mental health-related sessions with their parent. One hundred transcripts depicting mental health visits were coded using the Conversation Analysis framework. Coding included inductive coding that came from analyzing the structure, or orderliness, of the visits and content discussed that affects SDM. Thematic qualitative analysis revealed that facilitators to SDM included collaborative engagement, parents being active in tailoring session content, and integrating the preferences, roles, and next steps for treatment among all participants. Barriers included unskilled interpersonal interactions undermining rapport, off-topic conversations becoming the session's focus, poor time management, and irregularly integrating parent/patient preferences into the clinician's decisions regarding the child's treatment. Additionally, visit content, structure, tone, and interpersonal engagement were factors that variably facilitated or served as barriers to patient participation in SDM and were integral to collaborative, family-centered care. These findings delineated characteristics of pediatric mental health conversations and identified areas to strengthen communication between parents, patients, and clinicians to shift toward more effective SDM and improve patient outcomes among Latinx families.

Critical consciousness and anti-racist action as rooted in family processes.

Racially ethnically marginalized communities in the United States are exposed to structural and interpersonal forms of racism that have harmful effects on their health, wealth, education, and employment (Centers for Disease Control and Prevention, Racism and Health. https://www.cdc.gov/minorityhealth/racism-disparities/index.html, 2021). Although a plethora of research exists outlining these harmful effects, research examining how youth from diverse backgrounds effectively combat racism is lacking. Emerging research demonstrates that families may play a key role in the development of critical consciousness and participation in anti-racist actions (Bañales et al., Journal of Social Issues, 2021, 77, 964; Blanco Martinez et al., American Journal of Community Psychology, 2022, 70, 278; Lozada et al., Journal of Black Psychology, 2017, 43, 493). Yet, many key family processes have not been examined in relation to youth development of anti-racist practices. The current study included a sample of 327 racially ethnically diverse emerging adults (Mage = 18.80, SD = 1.28, range = 18-25), and explored the association between ethnic-racial socialization (cultural socialization, preparation for bias) and youth critical consciousness (reflection, motivation, action) and anti-racist (interpersonal, communal, political change) actions, and how familism values impact these associations. Results found that ethnic-racial socialization was positively associated with all aspects of critical consciousness and anti-racist actions. Results also found that familism significantly interacted with ethnic-racial socialization to predict some aspects of critical consciousness and anti-racist actions, but not others. Implications of the findings and future research directions are discussed.

Language proficiency and ethnic-racial orientation among Latine mother-adolescent dyads.

Language proficiencies have implications for how parents and children can communicate effectively and how culture and heritage can be transferred across generations. Previous research has sought to understand the relationship between parent language (mainstream, heritage) proficiencies and the ethnic-racial orientation of their children, though prior studies have not investigated the relationship between child language proficiencies and parent ethnic-racial orientation. This study examined the actor-partner effects of Latine mother-child dyads (N = 175; youth mean age = 12.86 years) regarding their proficiencies in English and Spanish and their Latine and White orientations. Our results revealed that youth Spanish language proficiency was positively linked to youth White orientation, and youth English proficiency was also positively associated with youth White orientation but only in instances when youth-reported acculturation conflict was lower or average. There were two partner effects observed, with youth English proficiency positively relating to mother's White orientation and mothers' Spanish proficiency being negatively related to youth White orientation. Regarding Latine orientation, both English and Spanish were positively related to greater Latine orientation for both mothers and their children. However, at higher levels of mother-reported acculturation conflict, higher mother English proficiency was related to lower youth Latine orientation. Overall, language proficiencies for Latine mothers and their children contribute to the development of bicultural orientations, though varying degrees of acculturation conflict can have differential impacts on these linkages.

Understanding how Latinx youth cope with discrimination: A call to action.

Racial-ethnic discrimination leads to poorer academic and mental health outcomes for Latinx youth. Although there is a growing literature on the resilience processes that shield Latinx youth from the negative ramifications of these experiences, there is limited work that specifically considers the coping behaviors and processes that youth enact to counter the harmful impact of racial-ethnic discrimination. This limited work is further hampered by a lack of measurement tools that account for the uniqueness of racial-ethnic discrimination as a stressor and the culturally relevant coping strategies endemic to Latinx populations. This article reviews the mixed findings among studies that have examined discrimination, coping strategies, and Latinx youth outcomes. Furthermore, the pressing need for a new measure that would better capture the nuanced manner in which Latinx adolescents cope with racism-related stress is outlined. This work concludes with methodological considerations as well as recommendations for the field's study of coping with the insidious impact of racism-related stress among Latinx adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

We got this: Evaluating racial socialization competency among diverse ethnic-racial groups.

Historically, research on racial socialization (RS) has centered on frequency, beliefs, and content of parent-child communications, with varied applications and implications across racial and ethnic subgroups. The Racial Socialization Competency Scale (RaSCS; Anderson et al., 2020) was developed to assess three dimensions of a novel construct, RS competency (confidence, skills, stress), among Black caregivers. In this article, we investigated the psychometric properties of the RaSCS across diverse ethnic-racial groups. Participants were 778 caregivers (Mage = 44.4 years) of youth between the ages of 10 and 18 recruited from across the United States. The sample was intentionally racially and ethnically diverse, with 26.1% identifying as Black, 24.2% identifying as Latinx, 24.9% identifying as Asian American, and 24.8% identifying as White. Confirmatory factor analyses replicated the previously identified structure of the RaSCS subscales, and scores were reliable. Multigroup measurement invariance analyses supported full scalar invariance across the four racial/ethnic subgroups for the Confidence, Skills, and General RS Stress subscales and partial scalar invariance for the Call to Action RS Stress subscale. These findings suggest that the RaSCS is an appropriate tool for assessing RS competency across racial and ethnic groups and that RS competency as a universal construct is relevant across groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differences and similarities between ethnic-racial identity and critical consciousness links among diverse parents of color.

Parents of color's critical consciousness development (understanding of and actions to redress societal inequalities) is an important yet understudied area, especially relative to the burgeoning literature on youth's critical consciousness development. As with youth of color, ethnic-racial identity, or the meaning and importance placed on one's ethnic-racial group membership, likely plays a notable yet complex role in parents' critical consciousness. Specifically, parents' participation in activities that engage them in the culture of their racial-ethnic group (exploration), the importance they place on race-ethnicity (centrality), and their perceptions of how society views their group (public regard) may each be differentially associated with understanding of inequalities (critical reflection), motivation toward ending inequalities (critical motivation), and the behaviors parents engage in to address inequalities (critical action). Further, it is possible that associations may vary across racial-ethnic groups given different sociocultural histories, experiences (including immigrant experiences), and positionality within the United States. In the present study, we employ multigroup structural equation modeling among a sample of 203 Black, 193 Asian American, and 188 Latinx parents (total N = 584, Mage = 44.46, SD = 2.49, 59.6% mothers) of an adolescent child between the ages of 13 and 17 to examine associations between ethnic-racial identity and critical consciousness across groups. Results indicate highly complex, group-specific relations between identity and critical consciousness: public regard was most consistently predictive of critical consciousness dimensions among Black parents. Exploration and centrality were most predictive among Asian American and Latinx parents, respectively. Implications for relations between ethnic-racial identity and critical consciousness in light of different group experiences are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural stress and critical consciousness among Latinx adolescents.

OBJECTIVE: To examine how cultural stressors (ethnic-racial discrimination, immigration-related threat, and COVID-19 stress) influence critical reflection, motivation, and action among Latinx adolescents and whether parental preparation for bias moderates these relations. METHOD: One hundred thirty-five Latinx adolescents (Mage = 16, 59.3% female, 85.2% U.S.-born) completed online surveys at two time points, 6 months apart. RESULTS: Immigration-related threat was associated with greater Time 1 (T1) critical reflection (ß = .31, p < .05) and Time 2 (T2) critical motivation (ß = .24, p < .01). Preparation for bias moderated the relation between immigration-related threat and T1 critical action (ß = .18, p < .01). COVID-19 stress was associated with greater T1 critical motivation (ß = .24, p < .01) and T2 critical action (ß = .18, p = .01). CONCLUSIONS: Cultural stressors may alert Latinx youth to systemic injustices in the United States, and combined with parental messages, may empower youth to address inequities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parental ethnic-racial socializations messages direct and indirect associations with shift-and-persist coping among minoritized American adolescents.

OBJECTIVES: The current cross-sectional study examined whether parental cultural socialization, preparation for bias messages, and adolescents' ethnic-racial identity (ERI) were associated with shift-and-persist coping strategy characterized by reappraising and accepting uncontrollable stressors (e.g., discrimination, poverty) while maintaining purpose and a positive future orientation. METHOD: Participants were 367 diverse ethnically/racially minoritized (42.2% Black, 25.9% Latinx, 16.1% Asian/Asian American, 12.5% multiracial, 3.3% from other groups) adolescents (Mage = 15.85, SD = 1.17, 68.9% girls). Structural equation models examined the direct effects of parental cultural socialization and preparation for bias messages on youth's ERI and shift-and-persist, as well as the indirect effects of socialization messages on shift-and-persist. RESULTS: Preparation for bias and cultural socialization were directly related to a stronger ERI for adolescents, but only cultural socialization was directly associated with greater shift-and-persist. Stronger ERI was associated with greater shift-and-persist, and both cultural socialization and preparation for bias were indirectly associated with greater shift-and-persist. CONCLUSIONS: Frequent parental preparation for bias may be indirectly associated with minoritized adolescent's shift-and-persist coping, whereas cultural socialization impacts youth's shift-and-persisting both directly and indirectly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Proactive coping with discrimination: A mediator between ethnic-racial socialization and Latinx youth's internalizing symptoms.

There is a dearth of knowledge in the coping literature on how minoritized youth cope with racism-related stressors and the predictors of effective coping responses. This two-wave study examined the direct and indirect effects of ethnic-racial socialization on depressive and anxiety symptoms via proactive coping with discrimination in a community sample of 135 Latinx adolescents (Mage = 16, SD = 1.27; 59% female). Results indicate that cultural socialization was related to higher use of proactive coping with discrimination 6 months later, which in turn, was related to fewer depressive and anxiety symptoms. There were no direct or indirect effects between preparation for bias and mental health outcomes.

Ethnic-racial identity and ethnic-racial socialization competency: How minoritized parents "walk the talk".

OBJECTIVES: Ethnic-racial identity (ERI) has important implications for individual psychosocial functioning as well as familial processes. For example, parents' ERI can shape children's developmental contexts through ethnic-racial socialization (ERS). Yet, existing research has tended to focus on the content or frequency of socialization messages themselves rather than on internal factors like socialization competence. Such competence, as reflected through confidence, skills, and stress, represents critical dimensions that permeate the socialization process and can impact the delivery of messages. The present study examines whether parents' ERI (i.e., private regard, centrality, exploration) is related to perceptions of their socialization competence. METHOD: Data from 203 Black, 194 Asian American, and 188 Latinx parents (N = 585, Mage = 44.46 years, SD = 9.14, 59.70% mothers) of adolescents between the ages of 10-18 were collected via Qualtrics panels. RESULTS: Across all parents, private regard, centrality, and ethnic-racial exploration were positively associated with perceived confidence and skills in engaging in ERS. Regard was additionally associated with lower socialization stress. CONCLUSIONS: The results point to consistent benefits of ERI in helping parents navigate ERS, furthering the understanding of ERI's developmental implications through parents' comfort with and ability to "walk the talk" with their children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Invisible targets: Conceptualizing U.S. Latine youth's exposure to family-level vicarious racism.

Vicarious exposure to discrimination can result in multiple negative outcomes in youth. In this article, we offer a conceptual model that articulates the intersecting contextual factors and potential moderators for U.S. Latine youth's exposure to family-level vicarious racism, and explore how that affects youth and family responses. We define and describe youth's exposure to family-level vicarious racism, considering the ramifications of these experiences through family processes and cultural values. We conclude by arguing that research on discrimination and racism in Latine families needs to account for family-level processes.

Ethnic and racial identity of immigrants and effects on mental health.

Robust research continues to broaden and deepen the field's understanding of immigrants' ethnic-racial identity and mental health. We highlight opportunities to pioneer the literature by questioning "who" is meant by immigrant (clearly defining generational status, going beyond covariate and difference-based approaches, focusing on immigrants from understudied ethnic-racial backgrounds), "what" is meant by identity (ethnic/heritage/native, conjoined with multiple identities such as national, regional, politicized), "where" experiences are taking place (globalization, differences in how immigrants are defined and viewed across contexts), and the "why" or importance of continuing this work (identity as resilience against mental health risks). Targeting under-researched intersections among the "who-what-where-why" can build knowledge and insight for researchers and practitioners who work with immigrant families, and perhaps for immigrants themselves.

Race terminology in the field of psychology: Acknowledging the growing multiracial population in the U.S.

The field of psychology is coming toward a critical juncture; scholars are increasingly recognizing that race, ethnicity, and culture play important roles in their fields of study, but do not always have the language to integrate race and culture into their own work. Furthermore, common conceptions of race may systematically exclude those from multiple racial and ethnic backgrounds in favor of fixed and discrete racial categories that ultimately perpetuate white supremacy. Meanwhile, as the Multiracial population of the U.S. is growing at an unprecedented rate, psychologists need language to acknowledge this population in their studies and pursue research to advance the field's knowledge of this diverse group and its many subpopulations. In an attempt to educate psychologists across subfields and disciplines, we provide a detailed account of preferred terms related to race and ethnicity with emphasis on ways to think about and talk about Multiracial populations in the United States. While preferred terms may change across time, the aim of this article is to provide psychologists with the tools to begin nuanced and necessary discussions about how race informs their research and the populations they work with in uniform and nonstigmatizing ways. By highlighting terminology related to those of multiple racial and ethnic backgrounds, we demystify and legitimize these rapidly growing but often hidden populations. Different perspectives on various terms are provided throughout to set psychologists on the path to beginning more race-conscious conversations and scientific inquiries into the experiences of Multiracial Americans and those from other marginalized racial-ethnic groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Facilitating the study of familism across racial/ethnic groups: Creation of the Short Attitudinal Familism Scale.

As the research on familism values, or cultural values relating to support, interconnectedness, and obligations has blossomed, scholars are increasingly interested in the applicability and impact of familism values across diverse racial/ethnic youth. However, existing measures of familism tend to be long, posing potential practicality issues and have not been validated for use across youth from different racial/ethnic groups. Through a series of conceptual steps and exploratory and confirmatory factor analyses, we developed the Short Attitudinal Familism Scale, a 6-item, shortened, unidimensional version of Lugo Steidel and Contreras's (2003) 18-item Attitudinal Familism Scale. This measure was created and validated in a sample of 671 Black, Latinx American, Asian American, and Multiracial youth (Mage = 17.23, 73.6% female). Multigroup measurement invariance testing indicated that the Short Attitudinal Familism Scale was almost wholly noninvariant and may be used reliably across racial/ethnic groups. Finally, we established construct validity by demonstrating negative associations with depressive symptoms in all but Asian American youth and positive associations between familism and ethnic-racial identity (ERI) for all youth. In conducting these tests using regressions using observed mean scores and structural equation modeling (SEM) using latent variables, we demonstrated that using a mean score of this scale led to small and negligible amounts of attenuation in estimates and similar statistical conclusions compared to those derived from SEM. Our study adds to the field by introducing a practical, unidimensional measure of familism values that may be used across racial/ethnic groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Shift and Persist in Mexican American Youth: A Longitudinal Test of Depressive Symptoms.

This paper tested whether shift-&-persist coping, or coping involving the combination of cognitive reappraisal, acceptance, and optimism (Chen & Miller, Perspectives on Psychological Science, 2012, 7, 135), attenuates the risks presented by economic hardship and ethnic discrimination for change in depressive symptoms from 9th to 12th grade, in a sample of 674 Mexican American youth (Mage W1 = 10.86; 50% female; 72% US born) and whether this effect depends on ethnic pride. Structural equation modeling indicated that, when accounting for economic hardship, shift-&-persist was associated with fewer concurrent depression symptoms. Youth with lower ethnic pride who endorsed high levels of shift-&-persist were protected against the negative impacts of peer ethnic discrimination on depressive symptoms. Future research on ethnic discrimination should examine patterns of coping and identity that can mitigate risk.

Examining the promotive versus the protective impact of culturally informed shift-&-persist coping in the context of discrimination, anxiety, and health behaviors.

This study aims to better understand how racially/ethnically minoritized youth exhibit adaptive psychological functioning (less anxiety) and health behaviors (better sleep and less binge drinking) in the context of discrimination, ethnic-racial identity and coping. Among 364 minoritized emerging adults (Mage = 18.79, 85.2% female), we utilized higher-order factor analysis to examine how culturally informed shift-&-persist (S&P), a higher-order construct explaining associations between coping factors (shift, persist, spiritually based coping, civic engagement), and ethnic-racial identity were related to anxiety, binge drinking, and sleep in the context of discrimination. Culturally informed S&P promoted better sleep and less anxiety controlling for discrimination. No significant effects were observed for binge drinking and no moderated effects were observed across outcomes. The harmful effect of discrimination on sleep was intensified for those with stronger ethnic-racial identities. The promotive and potentially protective effects of culturally informed S&P coping differs across mental health and health behavior outcomes.

Critical civic engagement in Black college students: Interplay between discrimination, centrality, and preparation for bias.

Critical civic engagement (CCE) refers to interpersonal, community, and political actions to combat and cope with racial inequity. While discrimination and identity are well-known drivers of civic engagement, it is less well-known how parental preparation for bias socialization, which teaches Black youth how to cope with unequal social systems, works in concert with discrimination and identity to predict CCE. Furthermore, there are several ways individuals may be civically engaged, and these factors may be differentially associated with the various types of CCE. This study uses a sample of 186 Black college students (Mage = 18.72, age range = 18-29; 86% female) to examine how discrimination, ethnic-racial centrality, and preparation for bias socialization interact to differentially predict interpersonal, communal, and political CCE. Discrimination was associated with political CCE, whereas both discrimination and racial centrality were associated with greater communal CCE. A three-way interaction between discrimination, centrality, and preparation for bias socialization predicted greater interpersonal CCE. Findings highlight the importance of attending to sociocultural factors when supporting Black college student activists in public minority-serving institutions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Familism and psychological wellbeing among Latinx youth: The role of parental alcohol use.

Familism is a central cultural value endorsed by Latinx youth that has been identified as a promotive factor for their psychological wellbeing (Stein et al., 2014). However, in the context of familial stress, familism values may instead serve to increase risk, but this research has not been extended to consider parental alcohol use as a risk context. Using a sample of 167 Latinx youth (Mage = 12.86, SD = 0.68, 52% female) from an immigrant community in the Southeast, we tested whether parental alcohol use moderated the association between familism values and youth depressive symptoms and self-esteem. Youth familism values were associated with greater self-esteem and fewer depressive symptoms. Parental alcohol use was not associated directly with either outcome, but, consistent with hypotheses, significantly interacted with familism values to predict self-esteem such that the promotive effect of familism on youth's self-esteem was not evident when parental alcohol use was high. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Shift-&-Persist and discrimination predicting depression across the life course: An accelerated longitudinal design using MIDUSI-III.

Life course theorists posit that sensitive periods exist during life span development where risk and protective factors may be particularly predictive of psychological outcomes relative to other periods in life. While there have been between-cohort studies trying to examine differences in discrimination and depressive symptoms, these studies have not been designed to identify these sensitive periods, which are best modeled by examining intra-individual change across time. To identify sensitive periods where discrimination and shift-&-persist (S&P) - a coping strategy that may protect against the negative impact of discrimination - are most strongly predictive of depressive symptoms, we employed latent growth curve modeling using an accelerated longitudinal design to track intra-individual change in depressive symptoms from ages 20-69. Participants were 3,685 adults measured at three time points ~10 years apart from the Midlife in the United States study (Mage = 37.93, SD = 6.948 at Wave I). Results identified two sensitive periods in development where high levels of S&P interacted with discrimination to protect against depressive symptoms; during the 30s and a lagged effect where 40's S&P protected against depressive symptoms when participants were in their 50s. Implications for the life course study of discrimination, coping, and depression are discussed.

Coping (together) with hate: Strategies used by Mexican-origin families in response to racial-ethnic discrimination.

Coping in the context of racial-ethnic discrimination is often framed as an individualistic process, where the focus is on how the individual deals with the racialized stressor to mitigate its negative effects. However, individuals exist within social contexts including the family and coping processes may operate interdependently as well. Further, racialized stressors have the potential to disrupt the entire family system, regardless of whether the experience in that moment is shared among all its members. Despite these realities, few studies have considered how Latinx youth and their parents may cope together in the face of racial-ethnic discrimination. To address this gap, we analyzed focus group data from Mexican-origin adolescents (n = 17; Mage = 12.8; 71% girls) and their parents (n = 17; Mage = 42.8; 82% mothers) to explore the coping strategies used in response to racial-ethnic discrimination. An inductive thematic analysis identified a broad range of coping strategies representing both individualistic and interdependent approaches to deal with racial-ethnic discrimination. Strategies included (a) reframing (with pride) and ignoring an encounter, (b) standing up for oneself, (c) talking issues out, (d) problem-solving together, and (e) protection tactics. These findings provide evidence for the ways in which Mexican-origin families help adolescents cope with racial-ethnic discrimination and offer a glimpse as to how adolescents may help their families cope as well. Future research is needed to further explore the interdependent nature of coping as Latinx family members protect and support one another in the face of pervasive racialized stressors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).