Family Cohesion's Impact on Psychotic Symptom Endorsement Among Latino Immigrants

Background:Latino immigrants living with psychotic symptoms are at risk for developing serious mental disorders, chronic medical problems and an overall decrease in quality of life. Acculturative stress, the tension involved in the process of integrating social norms, values and behaviors of the host country, can further exacerbate the stressors associated with psychotic symptoms. Prior studies focused on the association between psychotic symptoms and acculturative stress. Family cohesion, the emotional bonding that family members have toward each other, has been shown in previous studies to buffer against various interpersonal and psychosocial stressors. Few or no studies have focused on the impact that family cohesion has on the psychological distress of those living with psychotic symptoms. The purpose of this study is to assess the mitigating influence family cohesion has on the relationship between psychotic symptoms and acculturative stress.

Method:Using data from the National Latino and Asian American Study (NLAAS), 216 Latino immigrants (43.7% Mexican, 14.4% Puerto Rican, 7.5% Cuban, 34.5% Other Latino) who reported psychotic symptoms in their lifetime were included in the study. Participants were evaluated using the Composite International Diagnostic Interview. Demographic, acculturative stress and family cohesion variables were categorized for logistic regression analyses. Three logistic regression models were analyzed sequentially to assess for covariate effects on psychotic symptom endorsement. Model one examined the effects of demographic factors on psychotic symptom endorsement. Model two examined demographic and acculturative stress. Family cohesion was added to the final model to examine its mitigating contribution to psychotic symptoms.

Results: Approximately 40% of respondents who reported psychotic symptoms in their lifetime immigrated to the United States between 18 to 34 years of age. Additionally, over 72% of respondents lived at least 11 years in the United States. Further analyses showed that respondents with a moderate amount of acculturative stress are associated with lifetime psychotic symptoms endorsement (OR=1.62 [95% CI 1.06, 2.50]). Additionally, high family cohesion was negatively associated with psychotic symptom endorsement (OR=0.46 [95% CI 0.29, 0.75]).

Discussion: Moderate degrees of acculturative stress and family cohesion pose a risk toward lifetime psychotic symptom endorsement among Latinos. High family cohesion has demonstrated its mitigating association with psychotic symptom endorsement. Findings suggest that maintaining harmonious interpersonal relationships within the family can indeed serve as a possible protective factor toward reporting psychotic symptoms in one’s lifetime. Although future studies must go beyond cross-sectional analyses to make any causal inferences, these results support interventions focused on improving familial relationships.