Psychological Acculturation, Perceived Discrimination, and Mental Health Among Puerto Rican Women

Background and Purpose: Puerto Rican women on the mainland are a rapidly growing Latina subpopulation who encounters ethnic, racial, and gender discrimination. Although they are U.S. citizens at birth, many still experience acculturation, the adoption of cultural patterns that differ from one's own, resulting in adjustments in person-environment fit. Discrimination has been linked to mental distress among Latinas. Given differences in ethnic identification and access to coping resources between low and high acculturated women, acculturation level may influence whether discrimination leads to mental distress. Research here is rare but could shed light on the role of acculturation as a risk or protective factor for mental health in women experiencing discrimination. Such knowledge can help advance effective culturally responsive social work practice and frame public policy and program development as social justice issues. This study examined whether psychological acculturation mediates the effect of discrimination on depression, anxiety, and/or nervous attack. Methods: We used a cross-sectional survey design. A convenient sample of community dwelling adult Puerto Rican women was recruited through church officials and community agencies and advocates. Participants (N=153) were primarily born in Puerto Rico (72%) with a mean age of 33.6; 55.6% had an annual household income below $14,999, and 42.3% had not completed high school. Surveys were administered in English (47.7%) and Spanish (52.3%). Measures included the Discrimination Stress Scale, the Center for Epidemiological Studies Depression Scale, the Anxiety Sensitivity Index, and a list of symptoms of nervous attack. Results: First, multiple regression analyses showed that discrimination did not directly predict depression, anxiety, or nervous attack but it had indirect effects through acculturation on both of them. Next we tested the significance of the indirect effects using a bootstrapping method. The indirect effect of discrimination on depression through acculturation was significant because the 95% confidence interval for the indirect path did not pass through zero (.0109, .3582). In addition, the indirect effect of discrimination on anxiety through acculturation was also significant. The bootstrapping method yielded a 95% confidence interval of (.0429, .5109). Although logistic regression indicated that discrimination did not have an indirect effect on nervous attack through acculturation, the bootstrapping analysis was also performed for this relationship, resulting in a 95% confidence interval that passed through zero (-.0195, .0375). Age, income, and education were used as control variables. Conclusions and Implications: In this sample, low acculturation was a risk factor for mental distress. Perhaps, stronger identification with Puerto Rican cultural patterns makes it harder to buffer the distress associated with overt negative messages denigrating their ethnic heritage. Isolation or lack of social support may be particularly acute restricting alternatives for effective coping. Social work practitioners should incorporate acculturation, discrimination, and mental health in the assessment process. They should also device strategies that empower, support, and assist with coping with these predicaments, which exacerbate the profound oppression Puerto Rican women already experience. Advocacy efforts could be directed to the development of more effective anti-discrimination laws and policies that take into account the adverse impact of discrimination on emotional well-being.