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Health & Place 15 (2009) 751–760

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Health & Place

1353-82

doi:10.1

� Corr

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From the family universe to the outside world: Family relations, schoolattitude, and perception of racism in Caribbean and Filipino adolescents

Cecile Rousseau a,�, Ghayda Hassan b, Toby Measham a, Nicolas Moreau a, Myrna Lashley c,Thelma Castro d, Caminee Blake e, Georges McKenzie d

a McGill University, CSSS de la Montagne (CLSC Park Extension), Youth Mental Health Team, 7085 Hutchison Street, Room 204-2, Montreal, Quebec, Canada H3N 1Y9b Universite du Quebec a Montreal (UQAM), Psychology Department, C.P. 8888, Succursale Centre-Ville, Montreal, Quebec, Canada H3C 3P8c John Abbott College, 21,275 Lakeshore Road, Ste-Anne-de-Bellevue, Quebec, Canada H9X 3L9d Batshaw, Youth and Family Centers, Weredale Park, Montreal, Quebec, Canada H3Z 1Y6e Jewish General Hospital, 4333 Cote Ste-Catherine Street, 2nd Floor, Montreal, Quebec, Canada H3T 1E4

a r t i c l e i n f o

Article history:

Received 17 April 2008

Received in revised form

28 October 2008

Accepted 17 December 2008

Keywords:

Immigrant

Adolescent

Mental health

Racism

School

92/$ - see front matter & 2009 Elsevier Ltd. A

016/j.healthplace.2008.12.004

esponding author. Tel.: +1514 273 3800x6452

ail address: cecile.rousseau@mcgill.ca (C. Rou

a b s t r a c t

Caribbean and Filipino immigrant families in Canada have much in common: the women have often

immigrated as domestic workers, first-generation children may be separated from their parents for long

periods, and they must deal with negative stereotypes of their ethnic group. This transcultural study

looks at the associations between family relations and adolescents’ perceptions of both their own group

and the host society, and analyzes how these affect their mental health. The results suggest that family

cohesion plays a key role in shaping adolescents’ perceptions of racism in the host country and in

promoting a positive appraisal of their own community, thus highlighting the need for a systemic

understanding of family and intergroup relations.

& 2009 Elsevier Ltd. All rights reserved.

Introduction

Family relations, often described in terms of conflict andcohesion, have a strong impact on adolescent mental health forboth immigrant and non-immigrant populations (Beiser et al.,2002; Fuligni, 1998; Wissink et al., 2006). Although the centralityof family relations may thus appear to be universal, immigrationprocesses entail a transformation both of the family and of itsdiverse members. This transformation interacts in complex wayswith the specific stresses associated with immigration per se, thepostmigration environment and the family’s adjustment tominority status (Foner, 1997; Weine, 2008). Thus, although familyinteractions do explain a large part of the variance in migrant andrefugee youth mental health (Rousseau and Drapeau, 1998;Rousseau et al., 2004), these interactions should be understoodthrough an ecological frame where environmental processesinfluence contextual interactions in complex ways (Bronfenbren-ner, 1986). This paper describes the association between familyrelations in migrant families and the broader environmentalprocesses in the host society. It examines in particular the impactof the experience of discrimination on families from two cultural

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sseau).

groups who share a similar migration trajectory characterized byprolonged family separations and a low socioeconomic status inthe host country.

Filipino and Caribbean adolescents in Montreal: different cultures, a

common journey

Women from the Caribbean and the Philippines account for thevast majority of domestic workers in Canada. The DomesticWorker Program was established in 1955 to address the shortageof workers prepared to accept low wages and undesirable workingconditions (Henry, 1994; Torczyner and Springer, 2001). Initially,black women from the Caribbean were solicited as immigrants,but since 1980, most immigrant domestic workers have comefrom the Philippines. Although many families value theseprograms as a doorway into Canada, they have paid a high price.Domestics are often intimidated and abused. Furthermore, thecommunities have to endure the condescending gaze of main-stream society. ‘Bear and forebear’ has been a strategy of womenfrom both communities as they pursue the dream of a betterfuture for their children through immigration, in spite of thedeskilling, racism, and stereotypes associated with their experi-ence as domestics (Bals, 1999; McKay and Philippine WomenCentre, 2002; Pratt, 2002).

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Left in the care of relatives back home, these women’s childrenusually immigrate a number of years after their mother. Thefamily reunification process, although frequently successful, oftengenerates family tensions and conflict, and adjustment difficultiesin the adolescents (Crawford-Brown and Melrose, 2001; Gopaul-McNicol, 1993; Lashley, 2000). In Quebec, where Caribbeanadolescents are over-represented in youth protection agenciesand placement facilities, host country professionals are concernedwith behaviors that they often interpret as signs of underlyingconduct disorders (Messier and Toupin, 1994; Normandeau andDouyon, 1995). Quebec institutions such as school boards, thepolice force, and social service agencies also perceive Filipinoyouth as having difficulties, although studies have not beenperformed to investigate this view. The communities themselvesperceive the transgressions of their youth as mostly influenced byenvironmental factors, especially a social climate of discrimina-tion during an adjustment period, a time when both theadolescent and the family are more vulnerable (Lashley, 2000).Worried that the involvement of health and social services wasfurther stigmatizing adolescents and not fully understanding offamily needs, a team of community representatives and research-ers, from the communities and the host country, launched acomparative research program to investigate the psychosocialadjustment of Caribbean and Filipino adolescents in Montreal. Thetwo communities who established links with the team ofresearchers through clinical encounters felt the need to overcomecultural stereotypes of their groups by demonstrating the effectsof a shared migration and postmigration environment. Theydecided to actively participate to design and research this topic. Ofcourse, beyond their common migratory journey, both commu-nities acknowledged and valued their differences.

The Filipinos are a very large and yet relatively understudiedgroup in North America (Espiritu, 1996; Espiritu and Wolf, 2001;Henry, 1994). Most come from an urban professional and middle-class background and have blended easily into the NorthAmerican landscape. Although they are very proud of their Asianroots, their homeland has been thoroughly Americanized as aresult of its experience as a former US colony (Carino, 1987). Thefamily is a source of cultural pride, and family cohesion, unity, andloyalty are highly valued (Wolf, 1997). Espiritu and Wolf (2001)suggest that an aversion to divorce may explain the highpercentage of intact nuclear families in spite of frequent reportsof family conflict. The few studies on Filipino adolescents portraythem as fairly successful economically and apparently wellacculturated. Espiritu and Wolf (2001) emphasize that the lowself-esteem and high depression levels particularly evident amongyoung Filipinos may express a dissonance between economicintegration and social and emotional adjustment, thus revealingthe paradox of rapid assimilation into the successful middle class.

In Afro-Caribbean societies, the family is primarily matrifocaland the household is often headed by a woman who assumeseconomic and childcare responsibilities (Henry, 1994; Lashley,2000; Smith, 1996). After immigration, the family is seen asprotection against the dangers of the street, and the transmissionof filial respect, and of spiritual and community values areemphasized (Yearwood, 2001). Parents have high expectations fortheir children’s education and want them to earn a degree(Kasinitz et al., 2001).

Bringing with them the collective legacy of a history of slaveryand colonization, Caribbean families arriving in North Americaencounter the US policy of assimilation as well as North Americanracial categories. For Caribbean adolescents, this often meansbecoming black Americans, which, according to (Gans, 1992), is amixed blessing. While this makes them part of a strong minority,it is, on the other hand, a minority that is often excluded frommainstream society. The Canadian ideology of multiculturalism

overvalues cultural, religious, and racial differences. Furthermore,the advent of political correctness in North America has resultedin racism becoming more subtle and thus more difficult todenounce (Henry and Tator, 2003; Razack, 1998). The impact ofthis shift on adolescents is not yet known.

Young immigrants also face a linguistic challenge: in themajority English-speaking provinces (i.e., outside Quebec), Car-ibbean adolescents are considered to be English speaking, butassessments of their academic abilities do not take into accountthe specificities of Caribbean speech (Ruck and Wortley, 2002). InQuebec, where the majority is French speaking, newcomers arelegally obliged to go to French schools. Caribbean adolescents, liketheir Filipino counterparts, experience this as an additional barrierto success and a betrayal of their expectations.

This paper addresses the following research questions:

1.

Is there an association between family relations and Caribbeanand Filipino adolescents’ perception of their minority status interms of perception of their own group (collective self-esteem)and of their relation with the host society (perception ofdiscrimination and attitude toward school)?

2.

What is the impact of the experience of separation fromparents during migration on family relations (cohesion—con-flict)?

3.

How are the family relations and the environmental percep-tions related to the mental health of the adolescents?

We hypothesized that 1—higher family conflict would beassociated with lower collective self-esteem and higher percep-tion of racism, 2—separation from family during the migrationprocess would be associated with more family conflict, and3—family cohesion would play a protective role, helping youngpeople cope with the postmigration context and in particularwith discrimination and negative social mirroring in the hostcountry.

Method

Two bodies of data are used in this mixed method research.First, a survey provided quantitative data describing the adoles-cents’ and parents’ perspectives on a number of individual, familyand social factors. Second, qualitative data collected through threefocus groups (with parents, adolescents, and community leaders)in each community, although not presented in its entirety, is usedto enrich the interpretation of the quantitative data.

Sample

The study population consisted of Caribbean and Filipinoadolescents and their families living in Montreal. Adolescentswere recruited through cluster sampling by the French andEnglish Montreal School Boards of regular public English andFrench high schools in areas with large Filipino and Caribbeancommunities. A total number of 11 high schools were selectedbased on the percentage of Caribbean and Filipino studentsenrolled who would be admissible to the study. Caribbeanand Filipino adolescents were identified from lists of studentsat the participating schools that register the country of birthof students and their parents upon admission. From theseregistries, a total population of 633 potential adolescents andtheir parents was targeted. To be eligible to participate in thestudy, students had to meet two criteria: 1—be an adolescent(12–19 years old) of Filipino or Caribbean origin; 2—be animmigrant (i.e., first-generation immigrant) or born in Canada to

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immigrant Caribbean or Filipino parents (i.e., second-generationimmigrant).

From the 633 potential adolescents and their parents, 75 werescreened upon a first check and 9 upon a second check as noteligible. From the remaining 549 eligible adolescents and theirparents, 48 could not be reached and 247 refused to participate.The final sample was thus composed of 254 adolescents and theirparents. The refusal rate for this study, 49.3% (247/501), is ratherhigh and constitutes one of its limitations. Upon interpreting thedata, it is important to keep in mind that a sample bias may bepresent and that consequently the sample may not be represen-tative of the total population of Caribbean and Filipino youthliving in Montreal. This may be particularly the case, since we donot possess information on the sociodemographic profiles of

254 adolescent participa

118 Caribbean adolescents & one

of their parents

11 high schools = 633 ado

558 eligible adolescen

549 eligible adolesce

Fig. 1. Admissibility and no-response d

Caribbean and Filipino adolescents who refused to take part in thestudy (Fig. 1).

Procedure

Eligible adolescents and their parents were sent an introduc-tory letter describing our research and informing them that aresearch assistant would contact them shortly. Research assistantscontacted the parents 2 weeks later and answered their questions,receiving a first oral consent from both the parent and theadolescent and setting an appointment for the interviews. Trainedresearch assistants were matched to respondents by gender, agegroup (i.e., young adults met with adolescents and older adults

nts

136 Filipino adolescents & one of their

parents

lescents

75 were screened as not eligible

upon one check

ts

9 were screened as not eligible

upon second check

nts

48 could not be reached

247 refused to participate

istribution of selected adolescents.

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met with parents) and ethnic origin, as discussed with communityrepresentatives, who favored this matching solution to helpreduce underreporting of discrimination and of problems ingeneral. Participant parents (one parent for each adolescent) andadolescents were each met individually and separately in thelocation they preferred (generally at home). After signing theconsent forms, data collection consisted of face-to-face structuredinterviews (questionnaires or scales) administered in French,English, or Tagalog, as preferred by the respondents.

Mental health and adjustment

The Achenbach System of Empirically Based Assessment: theChild Behavior Checklist (CBCL), and Youth Self-Report (YSR)(Achenbach, 1991) were used to assess adolescent participants’overall mental health and social adjustment. The internalizing andexternalizing cross-informant scales were used. The CBCL and YSRhave been used extensively in educational and psychologicalresearch with ethnically diverse populations and are considered toremain robust in transcultural settings (Achenbach and Rescorla,2001; Bird, 1996; Crijnen et al., 1997; de Groot et al., 1996;Verhulst and Achenbach, 1995) validated French and Tagalogtranslations of the CBCL and YSR were already available. In oursamples, YSR internal consistency coefficients were .81 and .85 forthe internalizing and externalizing scales in the Caribbean sample,and .86 and .88 for the internalizing and externalizing scales inthe Filipino sample. The CBCL internal consistency coefficientswere .83 and .87 for the internalizing and externalizing scales inthe Caribbean sample, and .79 and .84 in the Filipino sample.These coefficients are considered ‘fair’ (o.80) or ‘good’ (.80–.89)(Cicchetti, 1994) given that in certain Asian communities evensolid instruments, such as the ASEBA, may yield lower reliabilitycoefficients (Rousseau et al., 1998).

Family variables

Family Environment Scale (FES): We used two subscales of TheFES (Moos and Moos, 1986) to assess conflict and cohesionbehaviors which different family members could adopt towardseach other. In previous research with refugee populations, the FEShas demonstrated good transcultural validity because of therelative clarity of the descriptions, which target behaviors ratherthan values (Rousseau et al., 2004). In this sample, internalconsistency coefficients were ‘poor’ (Cicchetti, 1994), rangingbetween .62 and .59 for the Cohesion scale and between .67 and.58 for the conflict scale in the Caribbean and Filipino adolescentsamples, which may reflect issues of social desirability andcultural norms around behaviors (Rousseau and Drapeau, 1998).

General Health Questionnaire (GHQ): We used a 12-item versionof the GHQ (Goldberg, 1972), which assesses symptoms of anxietyand depression (Gouveia et al., 2003). The GHQ has been used inseveral countries and is considered to be a good instrument tostudy culturally diverse immigrant populations (Kirmayer et al.,1996). The internal consistency alphas were ‘good’ for theCaribbean parents (.86) and ‘fair’ for the Filipino parents (.79)(Cicchetti, 1994).

Perception-of-world variables

Collective Self-Esteem Scale (CSES): This 16-item scale (Luhtanenand Crocker, 1992) was developed to assess individuals’ percep-tion of their collective ethnic identity. The CSES has been usedwith adults and adolescents in cross-cultural settings (Rahimi andBlake, 2001; Rousseau et al., 2003). Internal consistency alphas forthe Caribbean sample were ‘poor’ for adolescents (.69) and ‘fair’

for parents (.78). In the Filipino sample, alphas were ‘good’: .81 foradolescents and .82 for parents (Cicchetti, 1994).

Experience of Racism Scale (ERS): The ERS (Noh et al., 1999a, b)measures individuals’ experience of aggression motivatedby racism. The scale is composed of 8 items (e.g., Have youever been threatened because of racism?) rated on a 4-pointLikert scale ranging from 1 (never) to 5 (always). The ERS hasbeen used in earlier studies with adolescents of minorityethnic groups, particularly among Asians (Rousseau et al.,2003). In our study, consistency coefficients were ‘good’for Caribbean adolescents (.80) and for parents (.86), ‘fair’ forFilipino adolescents (.71) and ‘good’ for parents (.80) (Cicchetti,1994).

School Attitude-Bonding (SAB): The SAB is a 26-item scalethat assesses students’ attitudes toward their teachers, theiracademic requirements, and their feelings of safety at school(Resnicow et al., 1995). Items are answered on a 4-point Likertscale ranging from 1 (strongly agree) to 4 (strongly disagree).Internal consistency coefficients for the present samples were‘good’: .83 for Caribbean and .82 for Filipino adolescents(Cicchetti, 1994).

Sociodemographic characteristics were assessed through a setof questions on gender, age, education fluency in host countrylanguage and income. Migratory characteristics were assessed viathe length of time since immigration, separation from parentsupon immigration (yes or no) and generational level (first orsecond-generation immigrant adolescent).

Focus groups

Some of the co-authors (Castro—McKenzie) are very involvedat the community level and have first-hand information on theMontreal Diasporas for both communities. Based on this knowl-edge, they organized two focus groups of community leaders(professionals in education, health or social work, religiousrepresentatives, and community workers), two groups for parentsfrom diverse socioeconomic backgrounds and two groups foryouth (14–25 years old).

The Filipino youth group was composed of 6 boys and 6 girlsand the parents’ group included 6 mothers and one father.The Caribbean youth group contained 5 boys and 5 girls andthe parents’ group included 6 fathers and 5 mothers. TheFilipino community leaders focus group consisted of 9 communityleaders, and the Caribbean leaders focus group participantnumber was not documented because of recording difficulties,while it was estimated at between 7 and 10. The focus groupsaddressed the following themes: community definition of suc-cessful adaptation and positive mental health for youth-problems in youth, explanatory models around these proble-ms—migratory journeys—acculturation challenges—familyrelations in the host country, and postmigratory context(school, peers, religion, and discrimination). The focus groupswere audio-taped and transcribed, except for the Carribeanleaders focus group, where notes were taken after the group.Members of the research team subsequently read the verbatimmaterial in order to identify the main categories emerging fromeach of the themes of interest. A consensus around the coding ofcategories and concepts was reached through discussion in orderto be able to compare the two communities without losing thespecificities of each one’s voices. The qualitative analysis wasperformed in four steps: (1) transcription of focus groups, (2)marking up of text to indicate categories of information, (3)transcription of information in each category for both commu-nities and qualitative analysis of content, and (4) comparison ofthe results of the two communities. In this paper, we present the

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results around the following categories: family relations–familyseparations, own community perception and perception ofdiscrimination.

Statistical analyses

Pearson correlations and t-tests were performed in order toexamine the link between family relations (family conflict orcohesion) and perception of the world (i.e., of one’s owncommunity and of the host society, collective self-esteem andperceived racism). Correlations and ANOVAs were conducted inorder to assess the possible links between the three levels ofexposure to separation and perception of family conflict andfamily cohesion. Hierarchical multiple regressions were thenconducted in order to measure the manner that exposure toseparation, family and world perception relate with one anotherwhen predicting their impact on adolescents’ mental health.A four block regression model was designed. The first blockconsisted of ‘family relations’ measured through family cohesion,family conflict, and parents’ perceived mental health. The secondblock was composed of the three levels exposure to the separationvariable. The third block included ‘perception of the world’assessed through adolescents’ perception of racism, attitudetoward school and collective self-esteem. The possible interveningeffects of gender and age on the link between separation, familyand perception-of-the-world variables and adolescents’ mentalhealth were controlled for by putting them into the fourth block ofthe regression analyses. Colinearity statistics (tolerance andvariance-inflation factor) were performed for covariates.

Table 1Descriptive information on Caribbean and Filipino adolescent and parent samples.

Variable Category Mean o

Caribbe

Age of adolescents 14.87 (1

Age of parents 42.09 (7

Years in host country for adolescents 6.62 (3

Years in host country for parents 19.14 (9

Gender of adolescents Girls 65 (5

Boys 53 (4

Gender of parents Female 119 (5

Male 17 (5

Separation due to immigration No 67 (5

Yes 48 (3

Immigrant generation First 59 (3

Second 56 (6

Family income Less than $12,000 14 (7

$12,001–$30,000 43 (4

$30,001–$50,000 39 (4

$50,001 and over 19 (3

Parents’ education Primary 16 (8

Secondary 44 (6

Postsecondary 58 (3

% Is in parenthesis except for age and years in host country where the standard deviat

Results

Descriptive and group comparisons

Distributions of adolescents’ age and length of time sinceimmigration were similar for the two ethnic groups, but thesamples differed significantly on several sociodemographic vari-ables (Table 1). Although the number of adolescents whoimmigrated with their parents was similar for both the Filipinoand Caribbean groups, more Filipino adolescents had immigratedseparately. In addition, there were more first-generation immi-grants among the Filipinos and more second-generation Carib-bean immigrants. Significantly more Caribbean families wereliving below the poverty line (annual household income under$12,000) and the parents had lower levels of education than theirFilipino counterparts (Table 1).

Differences in terms of mental health, perception of the worldand family variables were mostly related to participants’ ethnicorigin (Table 2). The Caribbean sample scored significantly higheron perceived racism and family conflict, but also on collective self-esteem in relation to their social group. Filipino adolescents,however, had higher rates of internalizing symptoms.

Links between separation upon immigration, perception of the world,

family relations, and mental health

Results in terms of the relationship between family andperception-of-the-world variables were distinct (Table 3). For

r percentage T-test/w2 p Value

an n ¼ 118 Philippines n ¼ 136

.56) 14.88 (1.74) �.037 .970

.73) 44.39 (6.15) 2.63 .009

.88) 6.19 (3.25) .693 .490

.78) 12.46 (6.13) �6.535 .0005

2.8%) 58 (47.2%) 3.497 .061

1.1%) 76 (58.9%)

3.8%) 102 (46.2%) .063 .802

1.5%) 16 (48.5%)

5.8%) 53 (44.2%) 7.768 .005

8.1%) 78 (61.9%)

8.3%) 95 (61.7%) 11.773 .001

0.9%) 36 (39.1%)

7.8%) 4 (22.2%) 9.025 .029

7.3%) 48 (52.7%)

2.9%) 52 (57.1%)

8%) 31 (62%)

4.2%) 3 (15.8%) 26.934 .0005

2.9%) 26 (37.1%)

5.2%) 107 (64.8%)

ion score is in parenthesis.

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Table 2Means and standard deviations for predictors and dependent variables.

Variables Philippines Caribbean t Test p Value

Mean (SD)

Mental health

YSR: externalizing 11.29 (7.01) 11.57 (7.18) .306 .760

YSR: internalizing 14.56 (8.30) 12.32 (6.69) �2.334 .020

CBCL: externalizing 6.69 (5.85) 8.08 (7.54) 1.66 .099

CBCL: internalizing 9.01 (6.25) 8.67 (7.01) �.405 .686

Perception of world

Collective self-esteem 83.78 (11.23) 86.96 (9.41) 2.426 .016

Perceived racism 11.04 (3.45) 13.27 (4.61) 4.381 .0005

School attitude 81.48 (7.31) 81.07 (7.13) �.452 .652

Family

General health 6.44 (3.84) 9.79 (5.89) 5.426 .0005

Family conflict 2.18 (1.77) 2.89 (2.13) 2.878 .004

Family cohesion 7.51 (1.55) 7.24 (1.71) �1.346 .180

Table 3Pearson correlations between perception-of-world and family variables.

Collective

self-

esteem

p Value Perceived

racism

p Value School

attitude

p Value

General health

Philippines .115 .181 �.100 .250 �.003 .974

Caribbean �.036 .700 .038 .682 .008 .935

Family conflict

Philippines .079 .360 .024 .780 �.192 .026

Caribbean �.029 .754 .335 .0005 �.122 .193

Family cohesion

Philippines .114 .185 �.132 .128 .308 .0005

Caribbean .256 .005 �.250 .006 .155 .098

Table 4Effect of perceptions of world and family relations on Caribbean adolescents’ self-

reported externalizing and internalizing symptoms.

Variables b t R2 F change

Externalizing symptoms

Perception of world

School attitude �.35 �4.04��� .29 14.91���

Perception of racism .35 4.36���

Collective self-esteem .002 .018

Family relations

Family cohesion .002 .018 .39 6.15��

Family conflict .32 3.39��

General health .15 1.93a

Sociodemographic

Age �.02 �.22 .39 .05

Gender (male) female �.02 �.22

Internalizing symptoms

Perception of world

School attitude �.24 �2.54� .14 5.95��

Perception of racism .26 2.94��

Collective self-esteem .08 .86

Family relations

Family cohesion �.13 �1.23 .22 3.91�

Family conflict .22 2.11�

General health �.02 �.24

Sociodemographic

Age �.17 �2.01� .31 6.60��

Gender (male) female �.24 �2.94��

Parenthesis indicates reference group for gender, all other variables are

continuous.a po.10.� po.05.�� po.01.��� po.0005.

C. Rousseau et al. / Health & Place 15 (2009) 751–760756

the Filipino sample, a significant negative correlation was notedbetween family conflict and school attitude. Conversely, thehigher the family cohesion, the better the attitude towards school.For the Caribbean sample, perceived racism correlated positivelywith family conflict and negatively with family cohesion, whichcorrelated positively with collective self-esteem.

Regression models for the Filipino and Caribbean samplesshared many similarities and some differences (Tables 4 and 5).Early in the analyses, it was noted that the exposure to separationvariable did not significantly relate to family conflict or cohesionnor did it contribute to the regression models. It was consequentlydropped in order to increase statistical power.

School attitude (b ¼ �.35), perception of racism (b ¼ .35), andfamily conflict (b ¼ .32) explained 39% of the variance inCaribbean adolescents’ externalizing symptoms and 22% of theirinternalizing symptoms (Table 4). The variance for internalizingsymptoms reached a level of 31% after we controlled for age andgender, as girls and younger adolescents reported more inter-nalizing symptoms in this sample.

For the Filipino sample (Table 5), school attitude and familyconflict were significantly related to adolescents’ externalizingsymptoms (explaining 19% of the variance) and their internalizingsymptoms (explaining 14% of the variance). However, as girlsreported significantly more internalizing symptoms, when gender

was controlled for, school attitude and family conflict accountedfor 25% of the variance in internalizing symptoms.

Regression analyses were also conducted using parents’ ratingsof their children’s internalizing and externalizing symptoms (CBCLscore). For the Caribbean sample, family cohesion (b ¼ �.29 and�.26) and parents’ symptoms of anxiety/depression (b ¼ .26 and.34) accounted for 26% of parents’ ratings of their adolescents’externalizing and internalizing symptoms. For the Filipinoparents, only their symptoms of anxiety/depression (b ¼ .31 and.45) were significantly linked to their perception of theiradolescents’ internalizing and externalizing symptoms (14% and21% of the variance explained). However, as Filipino parentsreported more internalizing and externalizing symptoms for sonsthan for daughters, the variance increased to 17% for theinternalizing scale and 25% for the externalizing scale whengender was controlled for.

Focus group results

The Filipino focus groups described the dual effect ofseparations caused by immigration. On the one hand, the childrenmiss their parents and idealize the reunification with them, whilethe parents are overburdened by work in the host country and donot have as much time for them as they wish. On the other hand,the children realize how much their parents have sacrificed forthem and feel indebted to them. They are proud of their parents’

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Table 5Effect of perception-of-world and family relations on Filipino adolescents’ self-

reported externalizing and internalizing symptoms.

Variables b t R2 F change

Externalizing symptoms

Perception of world

School attitude �.21 �2.32� .07 3.30�

Perception of racism .12 1.44

Collective self-esteem �.03 �.29

Family relations

Family cohesion �.09 �.95 .19 5.99��

Family conflict .26 2.91��

General health .15 1.82a

Sociodemographic variables

Age .01 .09 .19 .07

Gender (male) female �.03 �.36

Internalizing symptoms

Perception of world

School attitude �.13 �1.41 .05 2.40%a

Perception of racism .17 1.96a

Collective self-esteem .01 .07

Family relations

Family cohesion �.12 1.31 .14 4.27��

Family conflict .24 2.63��

General health �.01 �.15

Sociodemographic

Age �.07 �.90 .25 8.91���

Gender (male) female �.36 �4.20���

Parenthesis indicates reference group for gender, all other variables are

continuous.a po.10.� po.05.�� po.01.��� po.0005.

C. Rousseau et al. / Health & Place 15 (2009) 751–760 757

courage and want to meet their expectations. This point isillustrated by a female Filipino teenager:

I think it also depends on the people that are counting on you,like your family. I think I’m successful if they’re proud of me orwhat they’ve expected actually happens when you come here.

Family reputation is very important and adolescents try tosucceed at school, even though they sometimes attempt toinfluence the specific forms that the parents want their academicsuccess to take. To the adolescents, desire for academic successappears to be linked to a cohesive family unit and to strongfeelings of belonging to it.

Filipino adolescents repeatedly described their parents asaccepting hurtful situations, not stirring things up, keeping quietabout injustice. While a number of them emulate their parents,although with difficulty, others speak up in spite of their parents’fear that this may get them into trouble. Some Filipinoadolescents thus have ambivalent feelings about their parents’attitude of forbearance around discrimination, as shown by afemale Filipino adolescent:

So I found that, you know, watching my parents not sayanything was very difficult for me, because it also made meunderstand that I shouldn’t be saying things, you know,because my parents aren’t saying things!

This challenge to Filipino immigrants in North America isrelated to the distinctive history of the Philippines. The Philip-pines experienced a double colonization, first by Spain, and thenby the United States. Arriving in North America, a Filipino-American racial categorization greets newcomers. The deskilling,stereotypes and abuse of domestic workers can be considered as acontinuation of colonialism (Pratt, 2002), and as an ongoingchallenge to Filipino community members to define who they arein their new country and the positive aspects of their Filipinoculture.

The non-recognition of Filipinos’ professional skills in the hostcountry and the enduring stereotypes of domestic workers are thekinds of discrimination most frequently mentioned:

[y] Filipinos always have to undergo such kind of work even ifyou have a profession or a degree? [y] Being a Filipino, you aregoing to be proud to see a lot of other Filipinos who areprofessionals. So if you see that, like, most Filipinos are justdomestic helpers, it is kind of disappointing. Why is it likethis? What’s going on? You feel that your own culture isdemoralized (Filipino girl).

However, beyond this injustice, the interviewed teenagers feelthat the future will be brighter and that changes in the socialstatus of Filipinos are possible.

The Caribbean focus groups underlines how respect—self-respect and respect for others—is the key value transmittedwithin the family. Family pride and cohesion appear to be stronglylinked to collective pride and collective self-esteem, as illustratedby a Caribbean father:

[y] Respect has always been very, very important, highlyimportant. [y] What I’m proud of, my pride I feel in my youngson, is when he walks on the street, he knows where he comesfrom. [y] Who you are, and where you come from—peopleneed to have this value.

Although they value this legacy, many youths in the focusgroup marveled at the ‘freedom’ they had both at home and atschool because of the absence of the multiple community parentalfigures they were used to in the Caribbean. Many also mentionedthe striking lack of structure and respect for authority in theclassroom. The immigrant dream is for children to succeed:children are expected to do better than their parents, to rise on thesocial ladder, to get a better education and subsequently improvetheir socioeconomic situation. Both parents and adolescentsrecognize that this dream puts very strong pressure on children,who are pushed to achieve their parents’ goals:

Every parent back home or here would like to see theirkids turn out to be something good. [y] When you comeup here, they expect too much from you, they expect a lotfrom you, they expect you to work your bones off. (Caribbeanboy)

Success however comes at a cost for the interviewed youth:adaptation to the host society is a must, but it is linked to loss,especially in terms of self-image, because of negative socialmirroring. For many, it is the first time that they have had toexperience themselves as the ‘other’. The process of seeingthemselves as different in a way that they had never beforeconceived of is extremely critical in their experience of the hostsociety. A Caribbean teenager mentions this:

Many of us came up here and want to make ourselves a betterperson, but we realize that for us, there are consequences,things that we have to go through which we are not used to.

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Deskilling, stereotyping, and subtle forms of racism aredenounced by young people and parents alike. Keeping alive thehope of a better future appears to be difficult, and lack of jobsseems to be the main obstacle. One Caribbean youth’s storyillustrates the problem vividly:

I think it really started to sink in how bad things are inMontreal when I was in college and I was job hunting with afriend of mine and [y] when you go for a job and you getrefused, I mean, it’s always in your mind y You’re not sure y

You’re never really sure. [y] So finally the counselor at theyouth employment said, ‘‘You know what, you guys have beenlooking hard for a job, this just came in, so I’m not going to postit. I’m just going to send you guys,’’ and I was excited. It was agood job, [y] We went there, and they didn’t give us the job,and we called back the counselor, and he said, ‘Really? Theyjust called back and they still need someone.’

The interviewed Caribbean youth thus appear to be caught in adouble bind: to fulfill the expectations of their parents andcommunity, they should invest massively in getting an education;at the same time, they should be realistic and pay attention to thehistorical wisdom and practical knowledge about the host societythat tells them that a good education does not guarantee access toemployment, often due to discrimination.

Discussion

Our results should be interpreted with caution because of themethodological limitations of the study. First, the high refusalrate, which according to community representatives reflects adistrust of host country institutions, as well as disillusionmentwith a situation over which they feel they have no control, limitsthe generalizability of the results. The fact that we could notcontact adolescents who had dropped out of high school may alsomake the sample less representative. Second, in spite of the caretaking in choosing the instruments, the relatively low internalconsistency of the conflict and cohesion scales may reflect thechallenges associated with culturally valid quantitative assess-ment of family relations (Stewart and Bond, 2002). Finally, asmentioned earlier, the design of the study does not allowdirectionality of associations to be inferred.

Family relations and perceptions of the environment areassociated with the adolescents’ self-reported emotional andbehavioral symptoms. More specifically, attitudes toward schoolare related to youth mental health for both communities whereasperception of racism is significantly associated with symptoms inthe case of Caribbean adolescents only. This confirms therepeatedly demonstrated importance in the literature of thequality of family relationships for adolescents’ mental health in allethnic groups (Chao, 2001; Dekovic et al., 2003; Wissink et al.,2006). It also replicates research on the relations betweendiscrimination, collective self-esteem and youth mental health(Rahimi, 2000; Rahimi and Rousseau, submitted). In spite of theassociations between family variables and environmental vari-ables observed in the bivariate analysis, interaction terms did notreach statistical significance in the global model, probably due tolimited statistical power of the regression models. Contrary toexpectations, the experience of extended separation from parentscaused by immigration does not appear, per se, to be associatedwith both internalizing and externalizing symptoms not withfamily cohesion or conflict. This pattern of associations suggeststhat postmigration reorganization of the family in the hostcountry and interaction with the host society may have a greaterimpact on young people’s successes or difficulties than the

migration-related family separation itself. Although separationduring migration is often described as a risk factor, in part becauseof confirmatory evidence from clinical studies, our results suggestthat its effects should be understood within specific culturalcontexts, taking into account not only the role of alternatecaregivers and the value assigned to them by the extended familyand the reference group (Lashley, 2000), but also the collectivemeanings associated with family separation (Rousseau et al.,1998).

In both communities, the gender effect on internalizingsymptoms follows the typical pattern of girls presenting moreanxious and depressive symptoms than boys. Parents’ perceptionsof their children’s symptoms is associated with their ownsymptoms of anxiety and depression, suggesting a contaminationeffect such as has often been observed (Rousseau and Drapeau,1998; Valla et al., 1993).

The bivariate associations between family relations andenvironmental variables read in the light of the focus groups,suggest that family cohesion may make it easier for young peopleof both groups to invest in the host society, although throughslightly different mechanisms: Caribbean adolescents with cohe-sive families tend to have lower perceptions of racism andincreased collective self-esteem, while the Filipino youth have amore positive attitude toward school. Family cohesion may thuspartially protect youth from the direct hardships of minoritystatus expressed through discrimination and from negative socialmirroring, which Suarez-Orozco defines as an internalization ofnegative mainstream views about ones’ ethnic group (2000).Positive family relations and a feeling of belonging may thus helpyouth to overcome these obstacles and prevent disillusionmentand feelings of hopelessness. This allows the Filipino youth toinvest the school with the belief that beyond the presentprejudices surrounding their community change is possible.However, for the Caribbean community, continuous exposure tostories of disappointment may also, push the young people to giveup on meeting their and their parents’ expectations, and thus stirup family conflict. Unfortunately, the literature confirms thepessimistic outlook of Caribbean youths toward their future andclearly shows that visible minorities do not have access toemployment and income levels corresponding to their levels ofeducation (Kunz et al., 2000). Racialized groups are still largelyover-represented in low-paying, low-status jobs (Galabuzi, 2001).

Much work has been done on acculturation, but relatively fewstudies have looked at the association between family dynamicsand the way in which immigrant adolescents perceive their ownand the mainstream communities. Examinations of familyinfluences on these perceptions have largely concentrated onthe idea of racial socialization and parental ability to buffer thenegative social mirroring of the host society (Suarez-Orozco andSuarez-Orozco, 2001). In a large survey of immigrant groups in theUS, Rumbaut (1994) found an association between family conflictand the perception of discrimination. Referring to the work ofGibson (1995) and Ogbu (1991), he suggests that this may be dueto the fact that the implicit outlook that sees discrimination astrumping education contradicts immigrant parents’ folk theoriesof success. He also observes that parent–child conflict is greater ifyoung people’s educational aspirations are low. In a comparativestudy of different migrant groups in the Netherlands, Wissink etal. (2006) hypothesize that the counter intuitive result linkingMoroccan adolescent perception of parental support to moredelinquency may be due to cultural influences in parenting style.These paradoxical findings may also reflect the loyalty of youthtoward parents who experience high levels of discrimination inthe host country. Our findings underscore the complex web ofmutual influences that may exist between family relations andadolescents’ perceptions of the external world. A more thorough

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understanding of these interactions could be useful in designingschool or community intervention and prevention programs thatbuild on the whole range of experiences of youths. Addressingparent–child and family–community relations is particularlyimportant in intervention and prevention programs, so that theusual school-home gap is not maintained or paradoxicallywidened in the helping process.

Conclusion

The subject of the study raises important ethical andideological issues, and this may partially explain why the relationsbetween family dynamics and perceptions of the environmenthave received relatively little attention. Linking family variables toperceptions of the host country and to perceptions of racism inparticular, runs the risk of reframing racism as a subjectiveconstruct, of significance mainly to vulnerable individuals orfamilies. This perspective minimizes the very real existence andexperience of racism in our society, and implicitly blames families,who not only must make all sorts of adjustments to the hostsociety, but are also held responsible for their adolescents’perceptions. Similar interpretation biases have occurred ininvestigations of personal and family risk factors for posttrau-matic stress disorder and attention deficit hyperactivity disorder(Singh, 2004), resulting in a tendency to minimize the importanceof social and environmental stressors, which are increasinglyviewed mainly as revealing underlying psychopathology or familydysfunction.

Although we strongly oppose this trend and believe that theelimination of racism and discrimination in all their forms shouldbe a social and political priority, we also believe that studying thefactors that protect children and adolescents from discriminationand negative social mirroring can be helpful in rethinkingintervention and prevention in this field. Our results support theview that, although priority should be given to decrease structuraldiscrimination by ensuring equal access to the job market andprofessional opportunities for minority youth (Williams et al.,2003), programs designed to address discrimination and inter-community tensions in multiethnic schools should take intoaccount the central role of the family in shaping the wayadolescents perceive these problems.

References

Achenbach, T.M., 1991. Manual for the Youth Self-Report and 1991 Profile.University of Vermont, Department of Psychiatry, Burlington, VT.

Achenbach, T.M., Rescorla, L.A., 2001. Manual for the ASEBA School—Age Formsand Profiles. Library of Congress, Vermont.

Bals, M., 1999. Les domestiques etrangeres au Canada: Esclaves de l’espoir.L’Hartman, Montreal.

Beiser, M., Hou, F., Hyman, I., Tousignant, M., 2002. Poverty, family process, and themental health of immigrant children in Canada. American Journal of PublicHealth 92 (2), 220–227.

Bird, H., 1996. Epidemiology of childhood disorders in a cross-cultural context.Journal of Child Psychology and Psychiatry 37 (1), 35–49.

Bronfenbrenner, U., 1986. Ecology of the family as a context for humandevelopment: research perspectives. Developmental Psychology 22, 723–742.

Carino, B., 1987. The Philippines and southeast Asia: historical roots andcontemporary linkages. In: James, T. Fawcett, Carino, B.V. (Eds.), PacificBridges: The New Immigrants from Asia and the Pacific Islands. Center forMigration Studies, New York.

Chao, R.K., 2001. Extending research on the consequences of parenting style forChinese Americans and European Americans. Child Development 72 (6),1832–1843.

Cicchetti, D.V., 1994. Guidelines, criteria, and rules of thumb for evaluating normedand standardized assessment instruments in psychology. PsychologicalAssessment 6 (4), 284–290.

Crawford-Brown, C., Melrose, J., 2001. Parent–child relationships in Caribbeanfamilies. In: Webb, N. (Ed.), Culturally Diverse Parent–Child and FamilyRelationships: A Guide for Social Workers and Other Practitioners. Ablex, WestPort, CT.

Crijnen, A.A.M., Achenbach, T.M., Verhulst, F.C., 1997. Comparisons of problemsreported by parents of children in 12 cultures: total problems, externalizing,and internalizing. Journal of American Academy of Child and AdolescentPsychiatry 36 (9), 1269–1277.

de Groot, A., Koot, H.M., Verhulst, F.C., 1996. Cross-cultural generalizability of theYouth Self-Report and Teacher’s Report Form cross-informant syndromes.Journal of Abnormal Child Psychology 24 (5), 651–664.

Dekovic, M., Janssens, J.M.A.M., Vanas, N.M.C., 2003. Family predictors of antisocialbehavior in adolescence. Family Process 42 (2), 223–235.

Espiritu, Y.L., 1996. Colonial oppression, labour importation, and group formation:Filipinos in the United States. Ethnic and Racial Studies 19 (1).

Espiritu, Y.L., Wolf, D.L., 2001. The paradox of assimilation. Children of Filipinoimmigrants in San Diego. In: Rumbaut, R.G., Portes, A. (Eds.), Ethnicities:Children of Immigrants in America. Russell Sage Foundation, New York,pp. 157–186.

Foner, N., 1997. The immigrant family: cultural legacies and cultural changes.International Migration Review 31 (4), 961–974.

Fuligni, A.J., 1998. Authority, autonomy, and parent–adolescent conflict andcohesion: a study of adolescents from Mexican, Chinese Filipino, and Europeanbackgrounds. Developmental Psychology 34 (4), 782–792.

Galabuzi, G.-E., 2001. Canada’s Creeping Economic Apartheid: The EconomicSegregation and Social Marginalisation of Racialised Groups. Centre for SocialJustice Foundation for Research and Education, Toronto.

Gans, H., 1992. Second generation decline: scenarios for the economic and ethnicfutures of the post-1965 American immigrants. Ethnic and Racial Studies 15(2), 173–193.

Gibson, M.A., 1995. Additive acculturation as a strategy for school improvement.In: Rumbaut, R.G., Cornelius, W.A. (Eds.), California’s Immigrant Children:Theory, Research and Implications for Educational Policy. Center for US-Mexican Studies, University of California, San Diego, pp. 77–105.

Goldberg, D.P., 1972. The Detection of Psychiatric Illnesses by Questionnaire: ATechnique for the Identification and Assessment of Non-Psychotic PsychiatricIllness. Oxford University Press, London.

Gopaul-McNicol, S., 1993. Working with West Indian Families. Guilford Press, NewYork.

Gouveia, V.V., da S. Chaves, S.S., de Oliveira, I.C.P., Dias, M.R., Gouveia, R.S., DeAndrade, P.R., 2003. The use of the GHQ-12 in a general population: a study ofits construct validity. Psicologia: Teoria e Pesquisa 19(3), 241–248.

Henry, F., 1994. The Caribbean Diaspora in Toronto: Leaning to Live with Racism.University of Toronto Press, Toronto.

Henry, F., Tator, C., 2003. Racial Profiling in Toronto: Discourses of Domination,Mediation and Opposition. Canadian Race Relations Foundation, Toronto.

Kasinitz, P., Battle, J., Miyares, I., 2001. Fade to black?: the children of West Indianimmigrants in southern Florida. In: Rumbaut, R.G., Portes, A. (Eds.), Ethnicities.Children of Immigrants in America. Russell Sage Foundation, New York,pp. 267–300.

Kirmayer, L., Galbaud du Fort, G., Young, A., Weinfeld, M., Lasry, J.C., 1996.Utilization of mental health services for psychological distress by immigrants.In: Quebec—Paper presented at the Annual Meeting of the Canadian Academyof Psychiatric Epidemiology.

Kunz, J.L., Milan, A., Schetagne, S., 2000. Unequal Access: A Canadian Profile ofRacial Differences in Education, Employment and Income. Canadian RaceRelation Foundation, Toronto.

Lashley, M., 2000. The unrecognized social stressors of migration and reunificationin Caribbean families. Transcultural Psychiatry 37 (2), 201–215.

Luhtanen, R., Crocker, J., 1992. A collective self-esteem scale: self-evaluationof one’s social identity. Personality and Social Psychology Bulletin 18,302–318.

McKay, D., Philippine Women Centre, 2002. Filipina identities: geographies ofsocial integration/exclusion in the Canadian metropolis. In: Paper presented atthe Research on Immigration and Integration in the Metropolis Working No.02-18, Vancouver, BC.

Messier, C., Toupin, J., 1994. La clientele multiethnique des centres de readaptationpour les jeunes en difficulte. Commission de protection des droits de lajeunesse, Quebec City.

Moos, H.R., Moos, S.B., 1986. Family Environment Scale Manual, second ed.Consulting Psychologists Press, Palo Alto.

Noh, S., Beiser, M., Hou, F., Kaspar, V., 1999b. Experiences of racism amongSoutheast Asian refugees in Canada. In: Roth, R. (Ed.), Psychologists Facing theChallenge of a Global Culture and Human Rights and Mental Health. PabstScience Publishers, Lengerich, Germany, pp. 503–515.

Noh, S., Beiser, M., Kaspar, V., Hou, F., Rummens, E., 1999a. Perceived racialdiscrimination, depression and coping: a study of Southeast Asian refugees inCanada. Journal of Health and Social Behavior 40, 193–207.

Normandeau, A., Douyon, E., 1995. Justices et communautes culturelles. Meridien,Montreal.

Ogbu, J.U., 1991. Immigrant and involuntary minorities in comparative perspective.In: Gibson, M.A., Ogbu, J.Y. (Eds.), Minority Status and Schooling: AComparative Study of Immigrant and Involuntary Minorities. Garland, NewYork, pp. 3–33.

Pratt, G., 2002. Between homes: displacement and belonging for second generationFilipino-Canadian youths. In: Paper presented at the Research on Immigrationand Integration in the Metropolis No. 02-13, Vancouver, BC, June.

Rahimi, S., 2000. Psychosocial correlates of collective self-esteem: a comparativestudy. Unpublished Master’s Thesis, McGill University, Montreal, Quebec,Canada.

ARTICLE IN PRESS

C. Rousseau et al. / Health & Place 15 (2009) 751–760760

Rahimi, S., Blake, C., 2001. The cultural consultation service database and web siteprojects. In: Kirmayer, L.J., Rousseau, C., Rosenberg, E., Clarke, H., Saucier, J.-F.,Sterlin, C., Jimenez, V., Latimer, E. (Eds.), Development and Evaluation of aCultural Consultation Service in Mental Health. Montreal: Culture and MentalHealth Research Unit Report, No. 11, Sir Mortimer B. Davis-Jewish GeneralHospital and Department of Psychiatry, McGill University.

Rahimi, S., Rousseau, C., submitted. Collective self-esteem and perception of racismamong Cambodian immigrants and French Quebecois. Canadian EthnicStudies.

Razack, S.H., 1998. Looking White People in the Eye: Gender, Race and Culture inCourtrooms and Classrooms. University of Toronto Press Incorporated, Torontoreprint 1999, 2001.

Resnicow, K., Ross-Gaddy, D., Vaughan, R., 1995. Structure of problem and positivebehaviors in African American youths. Journal of Consulting and ClinicalPsychology 63 (4), 594–603.

Rousseau, C., Drapeau, A., 1998. Parent–child agreement on refugee children’spsychiatric symptoms: a transcultural perspective. Journal of the AmericanAcademy of Child and Adolescent Psychiatry 37 (6), 629–636.

Rousseau, C., Drapeau, A., Corin, E., 1998. Risk and protective factors in CentralAmerican and Southeast Asian refugee children. Journal of Refugee Studies 11(1), 20–37.

Rousseau, C., Drapeau, A., Platt, R., 2004. Family environment and emotional andbehavioral symptoms in adolescent Cambodian refugees: influence of time,gender, and acculturation. Medicine Conflict and Survival 20 (2), 151–165.

Rousseau, C., Drapeau, A., Rahimi, S., 2003. The complexity of trauma response: a4-year follow-up of adolescent Cambodian refugees. Child Abuse and Neglect27 (11), 1277–1290.

Ruck, M.D., Wortley, S., 2002. Racial and ethnic minority high school students’perceptions of school disciplinary practices: a look at some Canadian findings.Journal of Youth and Adolescence 31 (3), 185–195.

Rumbaut, R.G., 1994. The crucible within: ethnic identity, self-esteem, andsegmented assimilation among children of immigrants. International Migra-tion Review xxviii (4), 748–794.

Singh, A., 2004. Doing their jobs: Mothering with Ritalin in a culture of mother-blame. Social Science & Medicine 59, 1193–1205.

Smith, R.T., 1996. The Matrifocal Family: Power, Pluralism and Politics. Routledge,New York.

Stewart, S.M., Bond, M.H., 2002. A critical look at parenting research from themainstream: problems uncovered while adapting Western research to non-Western cultures. British Journal of Developmental Psychology 20 (3),379–392.

Suarez-Orozco, C., Suarez-Orozco, M.M., 2001. Children of Immigration. HarvardUniversity Press, Cambridge, MA.

Torczyner, J., Springer, S., 2001. The evolution of the black community of Montreal:change and challenge. In: Paper presented at the McGill Consortium forEthnicity and Strategic Social Planning, Montreal.

Valla, J.-P., Bergeron, L., Breton, J.-J., Gaudet, N., Berthiaume, C., 1993. Informants,correlates and child disorders in a clinical population. Canadian Journal ofPsychiatry 38, 406–411.

Verhulst, F.C., Achenbach, T.M., 1995. Empirically based assessment and taxonomyof psychopathology: cross-cultural applications. European Child and Adoles-cent Psychiatry 4, 61–76.

Weine, S., 2008. Family roles in refugee youth resettlement from a preventionperspective. Child and Adolescent Psychiatric Clinic of North America 17,515–532.

Williams, D.R., Neighbors, H.W., Jackson, J.S., 2003. Racial/ethnic discriminationand health: findings from community studies. American Journal of PublicHealth 93 (2), 200–208.

Wissink, I.B., Dekovic, M., Meijer, A.M., 2006. Parenting behavior, quality of theparent–adolescent relationship, and adolescent functioning in four ethnicsgroups. Journal of Early Adolescence 26 (2), 133–159.

Wolf, D.L., 1997. Family secrets: transnational struggles among children of Filipinoimmigrants. Sociological Perspectives 40 (3), 457–482.

Yearwood, E.L., 2001. ‘‘Growing up’’ children: current child-rearing practicesamong immigrant Jamaican families. Journal of Child and AdolescentPsychiatric Nursing 14 (1), 7–40.