Biomedical subjects

E S Hishinuma

Publications and source records attributed to E S Hishinuma.

18 recordsLinked to original sources

PubMed2001

Prediction of DISC substance abuse and dependency for ethnically diverse adolescents.

PURPOSE: This study examines the validity of selected items from the Substance Abuse Subtle Screening Inventory-Adolescent (SASSI-A) version in predicting Diagnostic Interview Schedule for Children (DISC version 2.3) Substance abuse and dependency (SA/D) for Native Hawaiian (i.e., indigenous people of the Hawaiian Islands) and non-Hawaiian adolescents (youth without any Native Hawaiian indigenous ancestry). METHODS: 542 students were randomly selected from the larger sample to participate in the DISC administration. Demographic information, SASSI-A scores, and DISC diagnoses were obtained for each student. Univariate and multiple logistic regressions were performed in the prediction of DISC SA/D. RESULTS: SASSI-A Factor 1, consisting of three items measuring substance use, was found to have the best utility, accounting for 18.1% of the variance, in predicting DISC SA/D. IMPLICATIONS: These results support selected SASSI-A items in screening for SA/D for Native Hawaiian and non-Hawaiian adolescents in Hawaii as compared to other community-based screening instruments for other populations.

Adolescent↗

PubMed2001

Sociocultural factors influencing adolescent preference and use of native Hawaiian healers.

OBJECTIVE: Few studies have examined the use of alternative therapies among adolescents. This study examines the predictors of Native Hawaiian healer preference in the treatment of physical or emotional problems as well as the predictors of healer use. DESIGN: This study is a longitudinal cross-sectional design. SETTING: The survey was conducted in five high schools in Hawai'i. PARTICIPANTS: 1,322 high school students selected preference for and/or use of allopathic or alternative practitioners. MAIN OUTCOME MEASURES: Grade level, gender, ethnicity and cultural identity were used to predict healer preference. Healer preference, socioeconomic status and health status were used to predict healer use. RESULTS: Identification with the Hawaiian culture was the strongest predictor of healer preference for both Hawaiian and non-Hawaiian adolescents. Mental health was also predictive of healer preference for non-Hawaiians. Healer use by Native Hawaiian adolescents was also predicted by Hawaiian cultural identity. Gender, grade level, and socioeconomic variables were not predictive of healer preference or use. CONCLUSION: Cultural identity plays a significant role in the preference and use of alternative practitioners, especially for minority adolescent populations.

Adolescent↗

PubMed2001

Equivalencies regarding the measurement and constructs of self-esteem and major life events in an Asian/Pacific islander sample.

Construct, scalar, and functional measurement equivalencies of the Rosenberg Self-Esteem Scale (RSES) and Major Life Events checklist (MLE) and the constructs assessed were investigated across groups differentiated on Hawaiian/part-Hawaiian and non-Hawaiian (e.g., Caucasian, Filipino, Hispanic, Japanese, and mixed/2 or more) ethnicity and gender. Initial results from maximum likelihood factoring with promax rotation showed that RSES negatively worded Item 5 loaded with the positively worded Items 1, 2, 4, 6, and 7 on 1 of 2 factors for Hawaiian/part-Hawaiian female participants. Similarly, negatively worded Item 8 and the same positively worded items comprised 1 of 2 factors for non-Hawaiian male participants. For the other 2 Ethnicity x Gender groups, factors were respectively comprised of the 5 positively and 5 negatively worded RSES items. Construct equivalence or simple (2-factor) structure underlying the RSES was indicated across the 4 groups after Items 5 and 8 were excluded from a subsequent factoring procedure. Simple structure showed that Factor 1 comprised the positively worded Items 1, 2, 4, 6, and 7, and the remaining negatively worded Items 3, 9, and 10 loaded on Factor 2. Scalar equivalence of the self-esteem and major life events measures was supported by the statistical nonsignificance of the Major Life Events x Ethnicity x Gender interaction effect in multiple regression models. The consistency in the absolute size and direction of the intercorrelations between overall self-esteem, self-esteem Factors 1 and 2, and major life events variables indicated the functional equivalence of respective measures and constructs assessed. Measurement equivalency findings concerning the RSES and MLE, the constructs measured, and their utility versus caution against their use in multiethnic studies were discussed.

Adolescent↗

PubMed2001

Sociocultural and community factors influencing the use of Native Hawaiian healers and healing practices among adolescents in Hawai'i.

Recently, there has been much emphasis placed on both alternative approaches to health care and the provision of culturally competent care. Despite these trends, few studies have examined the use of alternative therapies on the part of adolescents. Even fewer studies have been done focusing on traditional Hawaiian approaches to health care. This is essential, especially in Hawai'i, where Hawaiians have not attained health parity with other majority ethnic populations, despite significant efforts and funding to achieve this end. This study examines the sociocultural and community factors influencing the use of traditional Native Hawaiian healers and healing practices by adolescents in Hawai'i. The Hawaiian High Schools Health Survey was administered at five high schools on three islands in Hawai'i during the 1993-1994 school year. The sample included 1,321 high school students who preferred either an allopathic or alternative practitioner. Ethnicity, gender, community access, healer preference, health status, level of education, and health insurance status were used to predict healer use and participation in healing practices. Community access and healer preference predicted both healer use and participation in native healing practices. Mental health predicted healer use (i.e., seeing a Native Hawaiian healer in the past six months), but did not predict taking part in native healing practices, such as ho'oponopono and lomilomi. Hawaiian ethnicity, female gender, and a measure of health insurance predicted participation in native healing practices, but not healer use. These results suggest that native healing practices and traditional healers are being used in Native Hawaiian communities and this is perhaps not due to a lack of health insurance. Given the general separation between Western and Native Hawaiian health services, traditional healing practices should be made available in Native Hawaiian communities to see whether a collaboration between Western practitioners and traditional healers can have a greater positive impact on the health of Native Hawaiians, particularly for adolescents.

Adolescent↗

PubMed2000

Psychometric properties of the Hawaiian Culture Scale--Adolescent Version.

This article reports on the psychometric properties of a newly constructed Hawaiian Culture Scale--Adolescent Version. A total of 2,272 Native Hawaiian and 1,170 non-Hawaiian adolescents were administered this 50-item inventory that measures the source of learning the Hawaiian way of life, how much Hawaiian beliefs are valued and important to maintain, how much non-Hawaiian beliefs are valued, Hawaiian blood quantum, and specific cultural traditions (seven subscales = Lifestyles, Customs. Activities, Folklore, Causes-Locations, Causes-Access, and Language Proficiency). The results strongly supported the internal consistency and validity of the measures for both the Hawaiian and non-Hawaiian groups. On the basis of the demographic data, partial support was offered for cross-cultural theories of ethnic identity. More consistent support was found for multiculturalism in Hawai'i's adolescents. Further research is needed to link these measures with indicators of psychological adjustment (e.g., depression, anxiety, substance use).

Adolescent↗

PubMed2000

Differences in State-Trait Anxiety Inventory scores for ethnically diverse adolescents in Hawaii.

This study examined the association between anxiety and 5 predictor variables: ethnicity (Caucasian, Native Hawaiian/part Hawaiian, Japanese, other), gender, grade level (9-12th), main wage earners' educational level, and State-Trait Anxiety Inventory (STAI; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) factors for a diverse group of students. Hawaiian students were found to have significantly higher levels of anxiety than Japanese students; however, ethnicity was not a significant predictor when gender, grade level, and main wage earners' education were statistically held constant. An interaction between ethnicity and STAI factor scores indicated an atypical pattern for Caucasians. Female students scored significantly higher than male students, and main wage earners' education predicted amount of anxiety. In general, these 2 associations remained significant when ethnicity and grade level were held constant. An interaction between gender and STAI factor scores indicated that the difference between female and male students was relatively larger for positively (as opposed to negatively) worded State items and for negatively (as opposed to positively) worded Trait items. Overall, the findings suggested that apparent ethnic differences in anxiety levels may be due to causal variables related to other sociodemographic variables. Factor scores in the form of positively versus negatively worded items should be considered an important variable; using only a global STAI composite as a measure of anxiety will mask the differential effects of the STAI factor scores. Further research is needed to determine the generalizability of these findings to other groups and to provide knowledge on direct causal variables that may account for a greater percentage of variance.

Adolescent↗

PubMed2000

Cultural identification and attempted suicide in Native Hawaiian adolescents.

OBJECTIVES: To determine rates of lifetime suicide attempts in a community sample of Native Hawaiian adolescents and determine the contribution of Hawaiian cultural affiliation, socioeconomic status, and psychiatric symptoms as risk factors for suicide. METHOD: High school students were surveyed in the state of Hawaii for lifetime suicide attempts, Hawaiian cultural affiliation, socioeconomic status, and symptoms of depression, substance abuse, aggression, and anxiety. Multiple logistic regressions were used on 3,094 subjects to develop prediction models for lifetime suicide attempts. RESULTS: Native Hawaiian adolescents had significantly higher rates of suicide attempts (12.9%) than other adolescents in Hawaii (9.6%). Hawaiian cultural affiliation rather than ethnicity was uniquely predictive of suicide attempts. Logistic regression indicated that depression, substance abuse, grade level, Hawaiian cultural affiliation, and main wage earner's education best predicted suicide attempts in Native Hawaiian adolescents, while depression, substance abuse, and aggression predicted suicide attempts in non-Hawaiians. CONCLUSIONS: Native Hawaiian adolescents have higher rates of attempted suicide than non-Hawaiian adolescents. Strong Hawaiian cultural affiliation rather than ethnicity is a risk factor for attempted suicide.

Acculturation↗

PubMed2000

Psychometric properties of the state-trait anxiety inventory for Asian/Pacific-islander adolescents.

Anxiety disorders are said to be universal across all cultures and recent reviews have found relatively high prevalence rates across different countries. However, the experience and interpretation of anxiety are strongly influenced by cultural factors. Demonstrating cross-cultural equivalence of measures of anxiety is essential to assure that comparisons between cultures will result in meaningful interpretations. Despite the State-Trait Anxiety Inventory being the most researched of anxiety measures from a cross-cultural basis, there is a lack of empirical studies on the psychometric properties of the STAI with adolescent Asian/Pacific Islanders. The present study examined the STAI using a large sample of ethnically diverse high school students in Hawaii. In general, a four-factor model (State-Anxiety Absent, State-Anxiety Present, Trait-Anxiety Absent, and Trait-Anxiety Present) provided the best fit based on a series of confirmatory factor analyses. Indicators of internal consistency supported the reliability of the factors and subscales, and the inter-factor correlations reflected positively on the concurrent validity of the different STAI factor and subscale measures. This study suggested cautious use and interpretation of one particular item (Trait Item 14 = I try to avoid facing a crisis or difficulty ), and cautious application of the STAI to Filipino adolescents (particularly Filipino males). Domains for further research are discussed.

Adolescent↗

PubMed2000

Alcohol use in Hawaii.

This article provides a review of the existing literature on alcohol use in Hawaii (i.e., epidemiology, reasons for use, associated problems, and intervention) and offers clinical implications of the findings and suggestions for further areas of research. In general, Caucasians, Hawaiians, younger Filipinos, males, adolescents, young adults, and those with lower educational attainment were found to be at higher risk. Overall, Hawaii's rates were either comparable or lower than those for the entire United States. Factors associated with different rates of alcohol use included accessibility, ability to resist offers, parent use and sanctions, peer influence and use, attitudes and beliefs (e.g., perceived normal drinking, dangerousness), religious affiliation, social occasions, and school intervention. Variable rates and trends in help-seeking behaviors, treatment admissions, and treatment utilization reflected the socio-cultural diversity in Hawaii. Perceived effectiveness of different treatments were generally consistent across ethnic groups, but did not necessarily represent actual efficacy. There is a clear need for additional prevention, screening, and intervention programs in Hawaii, including socio-culturally appropriate ones, as well as a need for further research.

Adolescent↗

PubMed1999

Two-year outcomes of psychosocial rehabilitation of black patients with chronic mental illness.

OBJECTIVE: Outcome as measured by psychosocial functioning was examined in a two-year follow-up study of 46 patients with chronic mental illness, 44 of whom were African American, who participated in an intensive psychosocial rehabilitation program based in a community mental health center. METHODS: Patients attended a program that operated seven days a week in a predominantly urban, black section of Baltimore. Level of functioning was determined at baseline and at six and 12 months using a scale based on data from the 1972 International Pilot Study of Schizophrenia. Parameters assessed included the length of time patients stayed out of the hospital, the frequency and depth of social relationships, dysfunction in work, the presence of symptoms, the ability to maintain personal hygiene, and the ability to participate in leisure activities. RESULTS: The sample was divided into three diagnostic groups: patients with schizophrenia alone (N=27), patients with a mood disorder (N= 12), and patients with a dual diagnosis of schizophrenia and a substance use disorder (N=7). Scores on the level-of-functioning measure were significantly correlated between baseline and six months, between six months and 24 months, and between baseline and 24 months. Statistical tests indicated a substantial and significant increase in level of functioning from baseline to 24 months for all groups. CONCLUSIONS: The results provide evidence for the effectiveness of an intensive psychosocial rehabilitation program for urban, black patients with chronic psychiatric illness, including those with a dual diagnosis.

Adult↗

PubMed1999

Trends across two time periods in the diagnosis of substance abuse comorbidity at the Hawaii State Hospital.

This study investigates the changes from the late 1980s to early 1990s of comorbidity (mental illness plus substance abuse) at the Hawaii State Hospital. For the 1990s, a prevalence rate ranging from 14.2% to 30% was estimated, with the latter figure based on a closer review of the records. A higher proportion of comorbid clients were single, and compared to the non-abusers (i.e., patients diagnosed with only schizophrenia or affective disorder), a higher percentage were male and had an educational level less than high school. There was an increase in the percent of non-abusers and substance abusers, but a decrease in the dual diagnosed. The implications of these findings are discussed.

Adult↗

PubMed1998

Prediction of major depression and dysthymia from CES-D scores among ethnic minority adolescents.

OBJECTIVE: The Native Hawaiian Mental Health Research Development Program is an epidemiological longitudinal study of adolescents residing in Hawaii. This article examines the utility of the Center for Epidemiologic Studies-Depression Scale (CES-D) for predicting DSM-III-R diagnoses of major depression (MD) and dysthymic disorder (DD) and investigates whether prediction differs by gender and ethnicity. METHOD: Diagnostic Interview Schedule for Children interviews were conducted with 556 adolescents randomly selected from among more than 7,000 students who had completed the CES-D. RESULTS: Six-month prevalence rates were as follows: MD = 8.5%, DD = 4.7%, either (MDDD) = 9.9%. Prevalence rates were significantly higher among females, but after CES-D scores were accounted for, gender no longer predicted depression in most analyses. When a cutoff score of 16 was used, classification accuracy was lower for Native Hawaiians than non-Hawaiians. However, after group differences in gender and grade level were accounted for, the predictive validity of the CES-D did not differ by ethnicity. CES-D factor 1 scores identified MD, DD, and MDDD about as well as the total score or all three factors together. CONCLUSIONS: These results support the validity of the CES-D for screening for depression among adolescents of Native Hawaiian and other minority backgrounds.

Adolescent↗

PubMed1998

Admissions, length of stay, and discharge barriers at the Hawaii State Hospital.

Based on data gathered from patients, psychiatrists, and social workers at the Hawaii State Hospital, it was determined that the majority of patients had been in the hospital for more than one year, were committed for forensic reasons, and did not need continued hospitalization. An inter-agency systems approach is needed to address the issue of length of patient stay.

Adult↗

PubMed1995

WISC-III accommodations: the need for practitioner guidelines.

According to professional standards and federal legislation, practitioners should provide reasonable test accommodations to eliminate discriminatory practices and to allow for an "even playing field." However, a contrasting view is concerned with the possible effects of deviating from standard administration procedures--meaningless scores and an unfair edge for individuals with disabilities. Particularly regarding the Wechsler Intelligence Scale for Children-Third Edition, practitioners are lacking guidelines in the following areas: (a) initial selection of tests to administer; (b) modifications in administration, if any; and (c) interpretation and reporting of results. Greater efforts are needed to formulate guidelines based on a synthesis of student needs, professional standards, federal legislation, psychometric theory, and empirical research.

Guidelines as Topic↗

PubMedDate not supplied

Prediction of anxiety disorders using the state-trait anxiety inventory for multiethnic adolescents.

The purpose of this study was to determine the validity of the State-Trait Anxiety Inventory (STAI) in predicting DSM-III-R anxiety disorders based on the Diagnostic Interview Schedule for Children (DISC, Version 2.3) and using Asian/Pacific Islander adolescents. An overall prevalence rate of 9.19% for generalized anxiety disorder, overanxious disorder, or social phobia was consistent with past studies. As hypothesized, STAI negatively worded (i.e., Factor 2) items were better predictors than positively stated (i.e., Factor 1) items. The STAI State mean was a better predictor of concurrent DISC anxiety disorders as compared to STAI State Factors I or 2. In contrast, the STAI Trait Factor 2 (negatively worded) composite was the best predictor for nonconcurrent DISC anxiety disorders as compared to STAI Trait Factor 1 or the overall STAI Trait subscale. Satisfactory predictive-validity values were obtained when using the STAI State mean and Trait Factor 2 composite. Implications of these findings are discussed, including using the STAI as a screening measure for ethnically diverse adolescents.

Adolescent↗

PubMedDate not supplied

Risk and protective factors related to native Hawaiian adolescent alcohol use.

The present study examined protective and risk factors in the prediction of alcohol use for Hawaiian and non-Hawaiian (i.e. Caucasian, Japanese, Filipino, 'other') adolescents. Comparable rates of approximately 25% were found for both the Hawaiian and non-Hawaiian samples regarding sometimes drinking too much alcohol. However, Hawaiians reported a statistically significantly higher rate (3.7%) of taking 'a drink in the morning to steady my nerves or to get rid of a hangover' than non-Hawaiians (1.3%). The reason for this is unknown but might indicate a higher rate of dependent alcohol use. The overall results supported the traditional model of protective and risk factors predicting alcohol use (R(2) > 15.0%), with relatively few differences found between the two ethnic groups. Further research is needed in assessing possibly unique cultural variables such as Hawaiian acculturation.

Adolescent↗

PubMedDate not supplied

NCAA college freshmen academic requirements: academic standards or unfair roadblocks for students with learning disabilities?

The National Collegiate Athletic Association (NCAA) has implemented sweeping legislation for all high school students who desire to participate in Division I or II freshman college athletics. Cutoff scores have been set by the NCAA in two areas: grade-point average (GPA) in "core" high school courses, and college-bound tests. High schools must obtain approval from the NCAA Initial-Eligibility Clearinghouse when determining core courses. Unfortunately, minimal attention has been given in the professional learning disability literature to the implications of the NCAA's policies, especially with regard to federal antidiscrimination legislation. Issues are raised regarding (a) the use of test score cutoffs, (b) a minimum GPA for core courses, (c) the responsibility of high schools, and (d) the lack of alternative eligibility procedures for accessing the essential elements of the NCAA's program. Options for consideration are provided in the context of meeting the needs of students with learning disabilities.

Achievement↗

PubMedDate not supplied

An update on NCAA college freshman academic requirements: the impact on students with LD.

A recent landmark settlement between the National Collegiate Athletic Association (NCAA) and the U.S. Department of Justice addressed many crucial issues relating to the eligibility of high school students with learning disabilities (LD) and their participation in college freshman athletics. Although the changes agreed upon in the consent decree should have wide-ranging ramifications generally in favor of students with LD, the more subjective nature of these changes opens the door for inevitable inconsistencies, biases, and possible abuses. In addition, larger issues remain unresolved, including (a) the NCAA's denial that is covered by the Americans with Disabilities Act, (b) the inconclusive status of whether college athletics is a major life activity, (c) the NCAA acting as a de facto national school board without rigorous research for setting policy on an informed basis, and (d) the lack of serious initiative on the part of the NCAA to take on a more supportive role in educational reform.

Adolescent↗