CMC Master's Thesis and Dissertation Abstracts

Doctoral Dissertation Abstracts:

Mootoo, Candace. (2019). Impact of Discrimination on Adolescent Well-Being: The Mediating Roles of American and Ethnic-Racial Identities. (Unpublished Doctoral Dissertation). Fordham University: New York, NY. 

Based on a sample of multi-ethnic adolescents, the purpose of this longitudinal study was (1) to examine the impact of ethnic-racial discrimination (ERD) on the private regard and centrality dimensions of both ethnic-racial identity (ERI) and American identity, (2) to determine the impact of these social identity variables on three indicators of mental health status: depressive symptoms, interpersonal conflict, and sleep quality, (3) to examine the potentially mediating role of these social identity variables in the associations between ERD and mental health outcomes and finally, (4) to investigate the extent to which sociocultural variables moderated the proposed mediation effect. Self-report data were collected from a multi-ethnic sample of 310 adolescents over three time points spanning a period of one year. Analyses centered on use of structural equation models to investigate the aforementioned effects. Though results did not provide direct support for a mediating role of the social identity variables in the association between ERD and mental health, results supported the extant literature, finding a significant negative impact of ERD and a positive impact of ERI private regard on depressive symptoms, measured one year and six months later, respectively. Results also elucidated impacts of ERD on ERI, measured six months later, that approached statistical significance– namely that ERD trended towards predicting an increase in ERI centrality and a decrease in ERI private regard. Also approaching statistical significance were negative impacts of ERI private regard on sleep quality, measured six months later. Gender emerged as an important factor, as findings that approached significance concerning ERI private regard were based on sub-samples that were comprised largely of adolescent girls, cohering with growing literature illustrating differential impacts of ERD and ERI by gender. Finally, the proposed sociocultural moderator variables – ethnic-racial group, nativity, and school ethnic-racial composition – were found to be significant moderators of the direct associations between social identity variables and both interpersonal conflict and sleep quality. Findings suggest that these moderating factors are key to understanding the meaning and impact of ERI and American identity for youth mental health.

Romero, Sara A. (2019). Cross-National Perceptions of Trauma. (Unpublished Doctoral Dissertation). Fordham University: New York, NY.

In 2003, the estimated lifetime prevalence of trauma exposure in the U.S. was 76%, which was comparable to the prevalence in Mexico (Norris, Murphy, Baker, Perilla, Rodriguez, & Rodriguez, 2003). Of the limited research examining cross-cultural differences, results suggest sociodemographic characteristics and the extent and type of trauma exposure are associated with PTSD (Atwoli et al., 2015; Norris et al., 2003) differently, if at all, between cultural groups. For Americans, the research indicates numerous sociodemographic correlates of PTSD (Goldstein et al., 2016). However, research has only identified a few sociodemographic correlates of PTSD for Mexicans (Medina-Mora Icaza, Borges-Guimaraes, Lara, Ramos-Lira, Zambrano, & Fleiz-Bautista, 2005). Furthermore, the relationship between PTSD and functional impairment (Charlson, Flaxman, Ferrari, Vos, Steel, & Whiteford, 2016; Gallagher & Mulvaney, 2004) and PTSD with posttraumatic growth (Berger & Weiss, 2006; Dunn et al., 2014; Steger, Frazier, & Zacchanini, 2008) has received limited consideration in cross-cultural research. Recent research indicates perceptions of trauma influence the expression of trauma reactions (Terheggen, Stroebe, & Kleber, 2001), which may explain the cross-national variance in PTSD prevalence between the U.S. and Mexico. This study identified correlates of PTSD symptom severity, functional impairment, and posttraumatic growth and differences in the association of perceptions of trauma difficulty with PTSD between American and Mexican respondents.

Sara Romero and Andrew Rasmussen
(Sara Romero with Dr. Andrew Rasmussen)

Roubeni, Sonia. (2015). Proximal Processes in the School Readiness of Head Start Children from Immigrant Families: Contributions of Region of Origin and the Home Learning Environment. (Unpublished Doctoral Dissertation). Fordham University: New York, NY.

The home environment, which includes parents’ engagement in children’s home learning experiences and preacademic stimulation, has important consequences for children’s acquisition of early academic skills, and although children of immigrants represent the fastest growing group of children in the U.S., little is known about their early learning contexts. The goal of the current study was to examine the mediating influence of the home learning environment on the relationship between parental region of origin and the school readiness of immigrant children upon entry into Head Start.

Data for this study were drawn from the Head Start Family and Child Experiences Survey of 2009 (FACES 2009), a national multisource study of Head Start children and their families. Structural equation modeling was used to estimate relationships between parental region of origin, the home learning environment, and children’s baseline cognitive, social-emotional, and executive functioning school readiness skills.

Results indicated that while children of Mexican, South American, Caribbean, and Asian descent had lower cognitive skills than children whose parents were from the U.S., children of immigrants were not significantly different in overall social-emotional competencies than non-immigrant children. Children whose parents were Mexican and South American performed lower on a task of executive functioning than U.S. children. Although children of immigrants had less  stimulating home learning environments than children of non-immigrants on average, children of immigrants had more enrichment experiences in the home than non-immigrants. This specifically applied to children of Mexican, Central American, South American, African, and Asian descent. After including model modifications, the home learning environment was found to mediate the relationship between region of origin and cognitive skills and social-emotional competencies.

Findings suggest that although children of immigrants in Head Start are at increased risks in cognitive domains of development, and although some immigrant subgroups are more socio-economically and educationally disadvantaged than other Head Start participants, their social-emotional competencies are on par with those of their counterparts. The fact that children of immigrants had more enrichment experiences in the home despite having had overall less stimulating home learning environments provides promising directions for future research. Findings were discussed in the context of ecological and ecocultural theories.

Master's Thesis Abstracts:

Zolopa, Camille. (2023). Recounting Trauma: Adjusting for Differences in Extreme Responding on PTSD Measures between Pan-ethnic Groups in the United States and Mexico. (Unpublished master’s thesis). Fordham University, Bronx, NY.

Background: Psychological measurements often ask respondents to select their answer choice from several ranked options. Scale usage is affected by many factors, including culturally socialized response styles, such as extreme responding. If unaccounted for, systematic extreme responding could skew scores, affecting both research and clinical assessment. Method: Extreme responding was operationalized by tallying endpoint responses on two measures related to but distinct from the target construct, Posttraumatic Stress Disorder (PTSD) symptom severity. Extreme responding was assessed among a gender-balanced sample of 1,820 participants: 936 in the U.S. (n = 312 Black; n = 312 Latinx; n = 304 White) and 884 in Mexico (n = 607 mestizo/a; n = 277 Indígeno/a). Results: Contrary to expectations, Mexican participants demonstrated less extreme responding than U.S. participants, driven by high levels of this response style among Black participants in the U.S. Extreme responding predicted PTSD scores beyond the contributions of environmental and sociodemographic factors. Two methods to account for the effects of extreme responding were attempted. Following ipsatization, intergroup differences remained significant; truncating scoring removed national differences in PCL-5 scores, but not all pan-ethnic differences. Discussion: Culturally influenced response styles, including extreme responding, represent an important source of potential measurement error. However, methods to assess and account for this form of bias have not yet been standardized, and questions remain as to the proportion of valid interpersonal variance that may be lost to standardization procedures. Future work is required to incorporate cultural response style into assessments in both research and clinical contexts.

Obianujunwa Anakwenze (2020). The Aversive Impact of Stigma on Black People Diagnosed with Schizophrenia. (Unpublished master’s thesis). Fordham University, Bronx, NY.

Compared to their White counterparts, Black people diagnosed with schizophrenia (PDWS) are at elevated risk for poor outcomes (e.g., greater likelihood of misdiagnosis, poorer treatment engagement, higher suicide rates). Although it is well known that there are racial disparities in schizophrenia treatment and service utilization, little is known about the mechanisms driving these disparities. Studies have found that Black Americans hold more negative attitudes towards mental illness than White Americans and that the impact of such stigmatizing attitudes on help-seeking for mental health problems is detrimental. Mental illness stigma may generate disparities in schizophrenia by delaying or preventing treatment seeking among Blacks.
This study sought to identify the mechanisms by which mental illness stigma, a racialized and politicized construct historically used to push Black Americans to the margins, acts as a barrier to care for Black PDWS and generates worse overall outcomes. It was hypothesized that Black PDWS who access routine outpatient care less frequently would be more likely to experience deterioration in their conditions and enter the mental health care system through less favorable inpatient access points. Depressive symptoms caused by stigma were thought to promote suboptimal patterns of service utilization, thereby resulting in increased substance use. Social support was expected to serve as a buffer against the harmful effects of stigma.
The hypotheses of this study were partially supported. Findings were consistent with prior research indicating that stigma is a determinant of psychological wellbeing in individuals with serious mental illness and that depression is one pathway by which the effect occurs. Stigma was found to be less detrimental at higher levels of social support. Additionally, this study provides some evidence that stigma generates negative outcomes by reducing use of outpatient mental health services in Black PDWS. This finding, which must be taken with caution, comes alongside the finding that usage of outpatient mental health visits is negatively associated with misuse of various substances.
Integrating perspectives from other disciplines, this study adds to the modest literature in psychology that either centers the experiences of Black Americans or examines stigma in relation to race. Its results have major public health implications. Indeed, this study was the first to examine the relationships among stigma, depression, service utilization, substance use, and overall behavioral health. Future research directions include examining whether there are differential levels of support for the proposed structural model across racial groups, whether Black men are more vulnerable to the disadvantages of mental illness stigma, replicating these findings with theory-driven covariates and in larger samples, conducting qualitative analyses to inform conceptualization of service use variables, and testing these research questions longitudinally.

Michelle Leon (2020). Susto and Cross-Cultural and Cross-National Differences in PTSD And Depression in Mexican And U.S. participants. (Unpublished master’s thesis). Fordham University, Bronx, NY.
Susto is a cultural concept of distress that is found in many Latin American populations and in some Latinx communities living in the United States. Susto is described as distress due to soul loss, or a sudden intense fear or traumatic event and is also used to describe the symptoms and sickness that follows the startling event. Susto is considered a culturally sanctioned effort to draw attention to one's social or medical necessities and can serve as a predictor of mental health problems. Research links susto and posttraumatic stress disorder (PTSD), as they are both etiologically defined by distress due to a sudden intense fear or a result from a traumatic event. While research associates susto with PTSD, there is a lack of research investigating symptom overlap between the illness and major depressive disorder (MDD), and how this may differ between specific ethnic groups. The aim of this thesis is to investigate differential symptom endorsement of self-reported PTSD and MDD symptoms associated with susto in a sample of multiethnic Mexican and U.S. individuals, (N = 1,812). This research provides partial support for susto as factor that may affect Mexican and US Latinx individuals’ and Mexican womens’ higher or more severe symptom endorsement for PTSD and MDD symptoms that relate to susto on the PCL-5 and BDI-II. The differential endorsement of symptoms of susto, PTSD, and MDD based on cultural group and culture-by-gender group comparisons, suggests that commonly used measures that assess for PTSD and MDD symptoms are not assessing these symptoms equally across groups and this has important implications concerning measurement invariance.

Cissé, Aïcha. (2018). Parent-Child Acculturation Dissonance in West African Families: A Grounded Theory Approach (Unpublished Master's Thesis, Manuscript in preparation). Fordham University, Bronx, NY.

The present study examined parent-child acculturation dissonance among West African Fulani immigrant families, using a sample of eleven participants consisting of five parent-child dyads and one adolescent whose parent was not interviewed. Individual qualitative interviews were conducted to explore acculturative processes and their impact on family relations and youth adjustment. Using a grounded theory approach for data analysis, the principal investigator identified the presence of parent-child acculturation in specific domains relating to religion, norms, values, behavior, and identity. Domain-specific parent-child acculturation dissonance was not found to be related to family conflict or youth maladjustment. On the contrary, results highlighted the presence of positive and stable parent-child relations and healthy psychosocial development in adolescents. Based on these findings, it was proposed that, among Muslim African immigrant families, maintenance of traditional African family values, adaptive and flexible parenting, and biculturalism in youths promote family cohesion and youth adjustment, while also buffering against the potential negative impact of parent-child acculturation dissonance. 

Ahmed, Sagal. (2017). Changes in social status and post-migration mental health outcomes among West African immigrants (Unpublished master’s thesis). Fordham University, Bronx, NY.

Immigration comes with rapid changes in social status that have effects on post-migration mental health. Research with nonimmigrant populations has identified relevant social status indicators, but these indicators are not sufficient to address changes that are uniquely relevant to immigrants. This study aimed to identify social status indicators that change during the process of migration, such as work status, spousal reunion, and immigration status, and to examine their association with distress using variable- and person-centered analyses.

Data indicating changes during migration was drawn from an archival data set from community-based participatory research project with West African immigrants in New York City. Social status change variables were created using pre- and post-migration demographic information. Mental health outcomes were the Anxiety, Depression, and Somatic subscales of the Brief Symptom Inventory and the Harvard Trauma Questionnaire. Regression analysis suggested that several social status indicators predicted wellbeing in this population, R2 range .15—.34. Ward’s method clustering suggested that three social status profiles existed, characterized by changes in work and changes in marriage or cohabitation. The cluster with the greatest positive changes in work was all female, and had the highest depression scores.

Findings suggest that not all types of change (i.e., negative, positive) in social status across migration are meaningful for post-migration mental health outcomes. Findings also suggest that changing gender roles across migration play an important role in post-migration mental health.

Mootoo, Candace. (2016). Family childcare providers’ job-related social support networks, burnout, and stress (Unpublished master’s thesis). Fordham University, Bronx, NY.

Background: Family childcare (FCC) providers face unique stressors, have complex job demands, and experience high stress.  Research on this population indicates that social support is associated with job stress and childcare quality but has not investigated job burnout, job competence, or the role of job self-efficacy. This study examined the job-related social support networks of FCC providers – assessing their ego-centric networks and network centrality – to investigate the link between social support and the aforementioned constructs.

Method: We recruited 19 FCC providers in New York City who were part of a network operated by an urban community-based organization, administering a semi-structured interview about their support networks and self-report questionnaires about perceived stress, job burnout, and job self-efficacy. We referred to the archival records from the providers’ organization to gather data on childcare quality and assessment completion, one component of job competence.

Results: Contrary to our hypotheses, having more providers in support networks predicted greater perceived stress and emotional exhaustion, and having higher support network centrality predicted greater emotional exhaustion. Having an assistant was associated with less emotional exhaustion; notably, most assistants were family members. In line with our hypothesis, job self-efficacy predicted lower perceived stress, lower emotional exhaustion, and greater assessment completion. There were no significant results related to childcare quality. Importantly, job self-efficacy moderated the relationship between social support and perceived stress, such that providers with low self-efficacy reported a positive relationship between support network size and perceived stress, while providers with high self-efficacy reported a negative relationship between these variables. With regard to job burnout, 26% of providers endorsed moderate to high levels of emotional exhaustion; 16% endorsed moderate to high levels of depersonalization; 16% endorsed low to moderate levels of personal accomplishment.

Conclusion: Results suggest that more social support for family childcare providers is not necessarily better, and that job self-efficacy is important for predicting provider stress. Results also suggest that job burnout is a phenomenon that affects FCC providers. Future research directions include investigating the mechanisms that underlie the relationships between social support and provider outcomes and job self-efficacy and provider outcomes.

Romero, Sara (2015). Depressed Latino elderly adults’ decision-making and information seeking preferences in Primary Care: Implications for patient-centered care (Unpublished master’s thesis). Fordham University, Bronx, NY.

The shared decision-making (SDM) model is the primary patient-centered approach to reduce racial and ethnic health disparities in primary care settings. Key factors of SDM, decision-making process and the desire to be knowledgeable of health-related information, has not been extensively explored to determine within-group differences in Latino older adults. This current study examines a multiethnic group of depressed elderly Latino primary care patients to determine whether specific sociocultural demographic factors influence patients’ preferences in the decision-making process and their desire to be knowledgeable of health-related information. More specifically, differences between Puerto Rican elderly patients and patients of other Latino heritages were examined to identify culture-specific determinants. A sample of 184 Latino patients who completed measures of decision-making preferences, information-seeking desires, depression severity, level of disability, and social service needs were examined. Results indicated level of income and disability were culture-specific determinants for decision-making preferences and information-seeking desires for Latino older adults. Regression models indicated Latino heritage moderated the relationship between depression severity and decision-making preferences related to depression treatment and general medical decisions. Specifically, Puerto Ricans with high levels of depression preferred to be more autonomous in making decisions related to general medical conditions compared to other Latinos. Puerto Ricans and other Latinos with depression preferred to share problem-solving responsibilities with healthcare providers at lower levels of depression. However, Puerto Ricans with low depression treatment preferred to be less autonomous in making decisions related to depression treatment compared to other Latinos. At higher levels of depression both groups preferred to share problem-solving responsibilities with healthcare providers. This investigation adds to the literature by examining sociocultural characteristics that influence decision-making preferences and desires to be informed of health-related information for Latino older adults. Future research is needed to examine differences between Latino heritage groups to improve participation in decision-making in primary care settings.