Disparities in depressive symptoms among adolescent children of immigrants and native adolescents

105 Pages·2014·0.77 MB·English

Disparities in depressive symptoms
among adolescent children of
immigrants and native adolescents:
Race, socioeconomic status, stress, and
social supports
Author: Jennifer Braga Leonardo
Persistent link: http://hdl.handle.net/2345/3779
This work is posted on eScholarship@BC,
Boston College University Libraries.
Boston College Electronic Thesis or Dissertation, 2013
Copyright is held by the author, with all rights reserved, unless otherwise noted.
BOSTON COLLEGE
Graduate School of Social Work

DISPARITIES IN DEPRESSIVE SYMPTOMS AMONG ADOLESCENT CHILDREN
OF IMMIGRANTS AND NATIVE ADOLESCENTS: RACE, SOCIOECONOMIC
STATUS, STRESS, AND SOCIAL SUPPORTS

A dissertation
by

JENNIFER BRAGA LEONARDO

Submitted in partial fulfillment
of the requirements for a degree of
Doctor of Philosophy

May 2013
© Copyright by JENNIFER BRAGA LEONARDO
2013
DISPARITIES IN DEPRESSIVE SYMPTOMS AMONG ADOLESCENT
CHILDREN OF IMMIGRANTS AND NATIVE ADOLESCENTS: RACE,
SOCIOECONOMIC STATUS, STRESS, AND SOCIAL SUPPORTS

A dissertation

by

JENNIFER BRAGA LEONARDO

Dissertation Chair: Dr. Thomas O’Hare

Abstract
Depression in adolescence is associated with a number of negative consequences,
including low school achievement, substance abuse, increased risk of later major
depression, and suicide. Adolescent children of immigrants are arguably at greater risk
of depression than their native counterparts, due to greater likelihood of migration-related
stress, a minority racial/ethnic background, lower socioeconomic status, and lower
proficiency in the host society language. Informed by theories of assimilation and social
network theory, this study examines the contribution of assimilation, sociodemographic
factors, and social supports to depressive symptoms in immigrant and native United
States adolescents. Nationally representative data on United States adolescents from
Waves I and II of the National Longitudinal Study of Adolescent Health (N = 4,263) are
analyzed. Results demonstrate immigrant adolescents report significantly higher levels
of depressive symptoms and more risk factors for depression than their native peers.
However, hierarchical regression analysis shows generational status ceases to be a
significant correlate of depressive symptoms when age, sex, race/ethnicity,
socioeconomic status, and home language are controlled. Mediation analysis shows
unique relationships between control variables, social supports, and depressive
symptoms. Findings are in accordance with social network theory, but challenge
assimilation theories premised on the assumption that immigrants face unique migration
related challenges that are overcome through generations. Findings support adolescent
children of immigrants and native children share common non-migratory related risk
factors of depressive symptoms, and adolescent children of immigrants are at greater
likelihood of experiencing these risk factors. Practice and policy implications are
discussed.

Keywords: health disparities, depression, assimilation, immigrant, adolescence, social
support, parental support, school support, peer support, intergenerational network closure,
stress
DEDICATION
To Maria Gertrudes and Joseph Peter Braga,
Mark S., Luke, Mark B., Samuel, and Sonya Leonardo,
it is in your presence and with your support that I feel most fulfilled, challenged, and
inspired to better understand our world, human relations, and serve others.
ACKNOWLEDGEMENTS
The completion of this work and my doctoral training is a shared experience. I
thank my parents, Maria Gertrudes and Joseph Peter Braga, for their unwavering support
and belief in my abilities. I thank my husband, Mark Leonardo, for his encouragement
and patience through this process. I thank my children, Luke, Mark, Samuel, and Sonya,
for their enthusiasm in life and unconditional love.
A special thanks is due to my wise and caring dissertation committee. Thank you
to Dr. Thomas O’Hare for a true appreciation of the learning process. Your mentorship is
mature, supportive, and encouraging. Thank you to Dr. Ce Shen, who taught me to
approach my work with a balance between theory and empiricism. Thank you to Dr. Eric
Dearing for your enthusiasm in my dissertation topic and patience and assistance in
learning new statistical procedures.
I sincerely thank Dr. James Lubben, the Director of the Boston College Graduate
School of Social Work Doctoral Program, and Brenda Vitale, the Assistant Director for
Academic & Student Services. You have provided a supportive learning environment, in
which I have grown intellectually. My wonderful cohort also deserves recognition. Kyle
Bourque, Jennifer Cole, Philip Higgins, Haesang Jeon, Christopher Salas-Wright, and
Abby Schwartz, we have supported and enjoyed one another through these years. I am
grateful for your friendships.

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TABLE OF CONTENTS
DEDICATION .................................................................................................................... v
ACKNOWLEDGEMENTS ................................................................................................. i
TABLE OF CONTENTS .................................................................................................... ii
LIST OF TABLES ............................................................................................................. iii
LIST OF FIGURES ........................................................................................................... iv
Chapter I. Introduction ........................................................................................................ 1
Purpose and Significance ................................................................................................ 1
Specific Aims .................................................................................................................. 4
Chapter II. Literature Review ............................................................................................. 6
Theoretical Framework ................................................................................................... 6
Conceptual Model ......................................................................................................... 15
Stress as a Risk Factor .................................................................................................. 17
Social Supports as Protective Factors ........................................................................... 20
Additional Protective and Risk Factors of Depression ................................................. 29
Research Questions ....................................................................................................... 31
Chapter III. Methods ......................................................................................................... 32
Study Design ................................................................................................................. 32
Sample Strategy ............................................................................................................ 33
Data Collection Procedures ........................................................................................... 34
Measures ....................................................................................................................... 35
Statistical Analysis ........................................................................................................ 43
Hierarchical Multiple Regression: An Overview ......................................................... 44
Mediation Analysis: An Overview .............................................................................. 46
Statistical Analysis Plan ................................................................................................ 48
Chapter IV. Results ........................................................................................................... 54
Chapter V. Discussion ...................................................................................................... 73
References ......................................................................................................................... 83
Appendix ........................................................................................................................... 92

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LIST OF TABLES
Table 1: Variables Used in Regression Analysis .............................................................. 57
Table 2: Correlation Analysis with Variables used in OLS Regression ........................... 59
Table 3: Ordinary Least Squares Hierarchical Regression ............................................. 61
Table A1: Comparison of Design and Analytic Samples .................................................. 93
Table A2: Depressive Symptoms Scale ............................................................................. 94
Table A3: Reliability Analysis .......................................................................................... 95
Table A4: Skew and Kurtosis of Variables Used in Regression Analysis ........................ 95

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LIST OF FIGURES
Figure 1: Conceptual model of how assimilation and background factors are related to
depressive symptoms through stress and social supports ................................................. 16
Figure 2: Mediation Analysis ........................................................................................... 47
Figure 3: Proposed model showing how stress and social supports mediate the
relationship between sex and depressive symptoms in adolescents ................................. 66
Figure 4: Proposed model showing how social supports mediate the relationship between
age and depressive symptoms in adolescents ................................................................... 67
Figure 5: Proposed model showing how stress and social supports mediate the
relationship between race/ethnicity and depressive symptoms in adolescents ................. 67
Figure 6: Proposed model showing how social supports mediate the relationship between
socioeconomic status and depressive symptoms in adolescents ....................................... 68
Figure 7: How stress and social supports mediate the relationship between sex and
depressive symptoms in adolescents ................................................................................. 70
Figure 8: How social supports mediate the relationship between age and depressive
symptoms in adolescents................................................................................................... 71
Figure 9: How stress and social supports mediate the relationship between race/ethnicity
and depressive symptoms in adolescents .......................................................................... 71
Figure 10: How social supports mediate the relationship between socioeconomic status
and depressive symptoms in adolescents .......................................................................... 72
Figure A1: Conceptual Model of How Social Networks Impact Health .......................... 92

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