Modeling psychopathology : the role of culture in Native Hawaiian adolescents

Abstract

This dissertation examines the unique history of Native Hawaiians and the literature on the sociology of mental health. It examines the role of Hawaiian culture, along with other structural and explanatory variables, in understanding the internalizing symptoms of depression and anxiety in a sample of Native Hawaiian adolescents. This study reviews theories regarding rapid social change, and models that aid our understanding of cultural loss and presents a theoretical model of how Hawaiian culture is affected by structural variables and where culture was learned and how culture, in turn, affects major life events and support, and how these variables are linked to internalizing symptoms. Existing data from the Native Hawaiian Mental Health Research Development Program (NHMHRDP) was used. These data included information from five high schools on three islands from the state of Hawaiʻi. Only Native Hawaiian students with complete information on the study's variables were included in the analyses (N=2142). Group comparisons and structural equation models were used to examine the role of Hawaiian culture in internalizing symptoms. There were significant differences found in categories of gender, socioeconomic status, and in the combination of the two. Univariate and multiple regression models indicated that major life events and family support accounted for the most variation in depression and anxiety. Hawaiian culture was significantly related, both directly and indirectly, to depression and anxiety, although it explained a small amount of variation on both outcomes. When the relationship between the variables was examined with structural equation modeling, the model for Native Hawaiian females had the best overall fit for the data and the variables used. Despite this, only small amounts of variance were accounted for in depression (12%) and anxiety (6%). Exploring other sociological concepts of anomie, social integration, alienation, and the subtle effects of racism and discrimination could be fruitful areas of further research in how Hawaiian culture affects not only psychopathology, but also overall health and wellness.