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NATURAL MENTORS, ETHNIC IDENTITY, AND
ADOLESCENT MENTAL HEALTH
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
To my mother for her unconditional love and for always being there.
To my grandmother for teaching me the value of education and lifelong learning.
And to the rest of my family and friends for all of their love and support
that made this possible.
I would like to acknowledge the contributions of my dissertation committee. I
acknowledge my dissertation chairperson, Dr. Jennifer H. Elder, for supervising a
project and a student that required expansion of her area of expertise. She has
demonstrated the qualities of a true scientist who is also sincerely committed to the
mental health care of children. I would also like to acknowledge Dr. Kathleen A. Long
for serving on my committee. She helped me to find a passion for the topic of mentoring.
She always considered my interests and dissertation project thoughtfully despite her
demanding role as dean of the college of nursing. I would especially like to thank the
final member of my committee from the college of nursing, Dr. Martha Jo Snider. She
has been my mentor since I was an undergraduate nursing student. She introduced me to
psychiatric mental-health nursing. I would like to thank her for her open-door policy and
for the professional and personal support she provided during my doctoral studies.
I would also like to acknowledge my dissertation committee members from
outside the college of nursing: Dr. Jennifer L. Woolard, from the Department of
Developmental Psychology, and Dr. Lisa M. Brown, from the Department of Clinical
Psychology. Dr. Woolard was instrumental in enabling me to work on her collaborative
research project with middle school students that became my dissertation. She also
demonstrated that a woman could have it all. She handled her roles as a professor and
mother with grace. I would especially like to thank her for attending my qualifying exam
while more than eight months pregnant. Lastly, I would like to thank Dr. Brown for her
passion for research and issues of race and ethnicity. She provided thoughtful and
insightful analysis of the theoretical and empirical work we discussed. She also was a
tremendous resource for me while I was completing my statistical analysis. She is a great
role model as an educator and a social scientist.
I would also like to acknowledge other groups and individuals who helped me to
complete my doctoral studies. Dr. Myrna Courage and the University of Florida provided
the Alumni Fellowship that allowed me to focus on my studies full-time. Also, Dr. Scott
Miller provided the opportunity for me to work as a research assistant while completing
my dissertation and allowed me to integrate my research questions into his survey
development project. Dr. Eve Brank, from the department of statistics, taught me about
data management and computer-assisted data analysis. Lastly I would like to thank Drs.
Stephanie and Elias Sarkis for their encouragement and their crucial advice about when
TABLE OF CONTENTS
ACKNOW LEDGM ENTS ................................................ iv
ABSTRACT .......... ................................................ viii
1 INTRODUCTION ........ ..........................................1
Problem .................. ................. ........... ........ 1
Purpose ............................ ..... .............. ..... .. 2
Conceptual Framework-Neuman Systems Model ......................... 2
M ental Health Functioning .... ............ ....................... 3
Middle-Range Theories ............................................ 4
Conceptual and Operational Definitions ............................... 8
Research Aims and Hypotheses ................ ...................... 13
Summary ....... ................................................ .14
2 REVIEW OF LITERATURE ................ ....................... 16
Relevance to Nursing-Adolescent Mental Health ........................... 16
Ethnic Identity ..................................... ................ 19
Mentoring ........ ................................................ 34
General Discussion .................................................. 46
3 METHODOLOGY .................................................. 47
Design ....... ..... .... .................................. 47
Research Aims ........ ............................................ 48
Research Hypotheses ................ ............................. 48
Procedures ........ .............................................. .48
Instrumentation ................. ............................ 51
Data Analysis ................ ................................ 56
Limitations ................ .................................. 58
4 RESULTS ................. .................................. 59
Research Design ................... .............................. 59
Sampling Procedure ................. ......................... 59
Sample Characteristics ................. ......................... 61
Mentors ................. ................. ............ ........ 63
Ethnic Identity ..................................................66
5 DISCUSSION AND RECOMMENDATIONS ............................ 72
Adverse Mental Health Outcomes ................ ................... 72
Mentoring ........ ............................................... .73
Ethnic Identity ...................................................75
Recommendations and Future Directions .............................. 78
Nursing Implications ............................................... 80
A MENTORING ITEMS ....................................... ....... 84
B PARENT INFORMED CONSENT ................. ................. 87
C VERBAL PARTICIPANT ASSENT ................................... 91
REFERENCES .............. .................................. 93
BIOGRAPHICAL SKETCH ............................................ 102
Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
NATURAL MENTORS, ETHNIC IDENTITY, AND
ADOLESCENT MENTAL HEALTH
Ramona Corrin Greig
Chair: Jennifer H. Elder.
Major Department: Nursing
Adolescent mental health research has undergone a shift in emphasis from
problem-focused to strength-based research. There has also been a shift toward more
research that is inclusive of ethnic minority group members and the constructs that are
particularly salient to them. This study explored individual and socio-cultural variables
and their relationships to adolescent mental health from a nursing perspective.
Ethnic identity development and the presence of natural mentors were examined
in a sample of 566 multi-ethnic middle-school students. Adolescent mental health was
assessed in the domains of mood-related symptoms (depressed/anxious mood,
angry/irritable mood, somatic complaints due to anxiety) and substance use (alcohol/drug
use). It was hypothesized that those adolescents with a natural mentor would have better
mental health than those without a mentor. It was also hypothesized that there would be a
relationship between ethnic identity achievement and mental health outcomes in the
African American and Hispanic adolescents. Lastly, a moderation model was tested to
examine the influence of an ethnically matched mentor on the relationship between
ethnic identity and mental health.
Multivariate analyses of variance, multiple linear regression, and logistic
regression were used to test these hypotheses. The hypotheses were not supported, with
one exception. Ethnic identity achievement was predictive of Alcohol/Drug Use for both
minority and majority adolescents. Ethnic identity achievement was not predictive of
mood-related symptoms possibly because of the early developmental age of the
participants. The presence of a natural mentor was also not predictive of mental health in
this sample, despite accounting for several aspects of relationship quality. Issues of
measurement validity and statistical power were limitations that may have influenced
these findings. Nonrandom sample selection, the use of a cross-sectional, correlational
design, and self-report measures were also limitations of this study.
This study has direct implications for nursing research, education, and practice.
Psychiatric-mental health nurses could use these findings to develop screening protocols
for mental health problems. Nursing education, practice, and research should emphasize
adolescent socio-cultural and psychosocial strengths.
Ethnic minority groups are a substantial part of U.S. society. Currently, Hispanics
and African Americans represent approximately 12% and 13% of the U.S population,
respectively (U.S Census Bureau, 2000). This is equivalent to over 32 million people in
each group. There is also little empirical knowledge about the mental health problems of
nonwhite adolescents (Grisso & Barnum, 2000). Therefore, it is critical for nurses and
other health professionals to include issues relevant to these groups in their research.
In addition, adolescent mental health is a growing concern for all ethnic groups.
More than half of early adolescents have had at least one physical fight in the last year
(Fetro, Coyle, & Pham, 2001; DuRant, Smith, Kreiter, & Krowchuk, 1999). More than
half of middle-school students have tried alcohol and more than 17% have tried
marijuana (Fetro et al.; DuRant et al.). By the time adolescents reach high school, their
rates of clinical depression reach adult levels with over 20% of adolescents being
affected (Lewinsohn, Rohde, & Seeley, 1998).
Research is needed that examines the relationships between individual and social
factors and mental health outcomes in adolescents. This area of research has typically
neglected factors that are relevant to ethnic minorities. Discovering what attributes or
strengths specifically may protect minority adolescents from emotional and behavioral
problems is an understudied area of research. More research also is needed that focuses
on positive factors that may be associated with better mental health outcomes for
The purpose of this study was to evaluate the relationships between ethnic
identity, mentorship, and adolescent mental health from a nursing perspective. Multiple
factors in various domains are related to mental health functioning. This study
specifically addressed these individual and social factors and their relationship to mental
health functioning in middle-school students.
Conceptual Framework-Neuman Systems Model
The Neuman Systems Model provides a broad conceptual framework for research
that focuses on issues from health promotion and disease prevention to acute illness. It is
one of the most widely used nursing models. According to Neuman (1995), nursing can
be defined broadly to include "prevention as intervention" (p. 33). Neuman defined the
client as a system that could potentially be an individual, a family, a community, or even
a social problem. The emphasis in the model is on system stability or health. For this
research, the system under consideration is that of an individual adolescent; and system
stability is defined as the absence of the signs and symptoms of mental disorder.
The client system is made up of several levels of protection from the onset of
illness (Neuman, 1995). The layers of protection are as follows:
* Flexible line of defense is an outer protective barrier to the client system that is
called into action first in the face of environmental stressors. It protects the wellness
or healthy state; and it can expand or contract based on changes in the system and the
environment. In this study, the presence of a mentor or a high level of achieved ethnic
identity may maintain mental health as evidenced by no adverse symptoms.
* Normal line of defense is the conceptual line that delineates and defines health. If
the normal line of defense is penetrated, illness has occurred and adverse symptoms
* Lines of resistance are activated after illness has occurred. Factors at this level move
the client toward recovery and health again. For example, an adolescent may seek out
social support from a mentor in response to depressive symptoms. The lines of
resistance are activated after the onset of symptoms and include any coping
mechanisms or responses that may lead toward recovery.
* Central core contains factors that are necessary for survival or are considered
common to all individuals. In the case of an individual, factors include bodily organs,
cognitive ability, genetic make-up and identity structure. Neuman (1995) described
the ego structure as a core construct. Aspects of this may be inherent (e.g.,
temperament). One's sense of identity also can be conceptualized as a core construct
that continues to develop over time. A further extension of this model is to
conceptualize ethnic identity as a core aspect of self that also develops over time.
The closer adolescents get to an achieved sense of ethnic identity, the more protected
they may be from the onset of adverse mental health outcomes.
A primary goal of nursing research is to identify existing and potential protective
and risk factors related to illness. Another goal is to develop theoretically based
interventions (Neuman, 1995; Fawcett, 2000). This study lays the foundation for
nursing interventions that could target individuals' strengths and assist them in resisting
illness or in returning to health after the onset of illness. This conceptual model provides
a guiding framework in this study of factors that are potentially protective against
adverse mental health outcomes in adolescents.
Mental Health Functioning
Mental health functioning is the outcome of interest in this research study. This
construct is extremely broad and complex. A detailed explanation of all of the factors
involved in determining this construct is beyond the scope of this project. However, this
construct fits easily into the systems model described above. Each level of the systems
model includes interacting variables from the physiological, psychological, socio-
cultural, developmental and spiritual domains (Neuman, 1995). Mental health
functioning is determined by a complex interplay among several domains and multiple
factors within each domain. This study targets concepts that are specifically in the
individual and socio-cultural domains and their relationship to mental health functioning
This section describes the theories that are specific to the variables under study.
These theories provide the groundwork for this study and much of the literature described
in Chapter 2. The social and developmental theories of ethnic identity are described, as
well as the theories related to the mentorship of adolescents.
Ethnic Identity Development
Using the developmental theories of Erikson (1968), and Marcia (1980), as well
as the social identity theory of Tajfel (1981), Phinney (1989; 1992) constructed a theory
of ethnic identity development that occurs during adolescence and early adulthood.
According to Erikson (1968), identity development is the primary task of adolescence.
During adolescence, the most logical framework for examining the construct of ethnic
identity is a developmental perspective.
Tajfel (1981) defined social identity as "that part of an individual's self-concept
which derives from his (or her) knowledge of his (or her) membership of a social group
(or groups) together with the value and emotional significance attached to that
membership" (p. 255). Social identity, in this context, is the aspect of identity related to
ethnic group membership. Ethnic group membership can enhance, have minimal effect
on, or be detrimental to general self-concept (Tajfel, 1981).
Ethnic identity is defined as a general phenomenon that applies to all ethnic
groups (Phinney & Tarver, 1988; Roberts et al., 1999). It is, however, of particular
importance to minority group members (Phinney, 1992). This probably occurs because,
when in the ethnic minority, ethnic group membership becomes a more important aspect
of identity. Phinney (1989; 1990; 1992) described three phases of ethnic identity
development: unexamined, exploration, and achievement. This differs from other
theories because it has been applied to many ethnic groups. The unexamined phase is
typified by the irrelevance of one's membership in an ethnic group to their self-concept.
The exploration phase is a period of increased participation in cultural activities,
increased interest in the history of their ethnic group, and increasing relevance to
personal identity. The achieved phase includes both a positive connection to one's group
and continued participation in cultural activities and behaviors (Phinney, 1992). This
study focuses on the level of overall ethnic identity achievement.
The two main theories that have been used to define and understand mentoring
are attachment theory (Bowlby, 1969; Ainsworth, 1989) and social learning theory
(Bandura, 1977). The definition of a mentor includes aspects of both theories. Neither
one independently allows for full understanding of mentoring. In combination, the
definition of a mentoring relationship becomes clearer and the mechanisms of any
benefits these relationships may provide to adolescents are better understood.
Ainsworth (1989) extended attachment theory beyond parent-child relationships
to friendships, pair bonds and other affectional bonds. Mentor-mentee relationships
include an affectional component (Rhodes, Ebert, & Fischer, 1992). These relationships
provide unique support that is not necessarily available within peer or parental
relationships (Beam, Chen, & Greenberger, 2002). There are several ways in which this
type of relationship may positively influence adolescents. It is possible that attachment
relationships with key non-parental adults, simply provide more social support (Rhodes,
Ebert, & Fischer, 1992; Scales & Gibbons, 1996). These relationships also may serve a
therapeutic purpose. They may be corrective relationship experiences in instances when
the parent-child relationships are insecure (Rhodes, Haight, & Ernestine, 1999). The
affective aspect of the mentor-mentee relationship can be easily conceptualized based on
The main concept from social learning theory that applies to mentoring is
observational or vicarious learning (Bandura, 1977). Vicarious learning is the ability to
learn from the behavior of others. One observes both the beneficial and detrimental
outcomes that result from specific behaviors. Positive role models demonstrate prosocial
behavior, and adolescents learn that this is a viable behavioral option. This defines one
mechanism of the behavioral influence of role models. Role modeling is a key concept
within the mentoring literature and in the development of mentoring programs (Cavell &
Hughes, 2000; Blum & Jones, 1993). Social learning has also been the basis of traditional
prevention efforts in the form of social skills training and other teacher-learner models of
intervention (e.g., Andrews, Hops, & Duncan, 1997).
Role modeling is, however, different from mentoring. Famous people or world
leaders can serve as role models without the context of a relationship. Mentoring has the
added component of a supportive, trusting relationship. In a review of youth program
evaluations, independent of the type of program, adolescents improved more on
behavioral outcomes if there were caring adults involved in program implementation
(Roth, Brooks-Gunn, Murray, & Foster, 1998). Consistent and stable relationships had an
impact on adolescent outcomes. This provides evidence that the ability of a mentor to
serve as a role model stems partly from the quality of the relationship between the
adolescent and the mentor.
In summary, it is possible that some adolescent-mentor relationships have more
of an attachment component, while others serve more of the role-modeling function. It is
also likely that the two functions of mentors may be inextricably linked. In other words,
for a mentor to have social influence on an adolescent, there must be an affectional bond
present. In this study, these two functions of the mentor-mentee relationship are not
differentiated. The presence of mentors in the lives of adolescents was assessed. In
addition, the emotionally supportive aspects of these relationships and the amount of
influence adolescents believe the mentor has over their life decisions and behaviors were
An additional characteristic of the adolescent-mentor relationship that this study
examined was the ethnic match of the mentor and the mentee. The theoretical
frameworks described above have not specifically addressed this concept. However,
social learning theory and social identity theory can be applied to the concept of an
"ethnic role model" (Brown, 1998, p. 170) and/or an ethnic mentor (the latter term is
used in this study). That is, the ethnic match of a mentor may facilitate vicarious learning
and may provide a sense of commonality that allows for easier attachment.
Mentoring programs for at-risk adolescents typically attempt to ethnically match
mentors and mentees; however, this is not necessarily theoretically or empirically
grounded. Ethnic matching has been studied in other areas. For example, research has
demonstrated that ethnically matching adoptive parents and children can enhance ethnic
identity for Hispanic adolescents (Andujo, 1988). However, the ethnic identity of
adolescents matched with mentors that have the same ethnic background has not been
extensively studied. An additional goal of this project was to assess the potentially
moderating effect that this ethnic match had on the relationship between an adolescent's
ethnic identity and his or her mental health functioning.
Conceptual and Operational Definitions
Mental Health Functioning
Mental Health Functioning is defined as the absence of adverse mental and
behavioral symptoms. It is differentiated from the broad construct of general healthy
psychological development. Healthy psychological development can broadly include
emotional, cognitive, and biological factors. This study focuses on the presence or
absence of adverse emotional or behavioral symptoms. The presence of these symptoms
has also been called psychopathology in the literature (Lewis, 2000). The investigation of
psychopathology over the course of adolescent development has been defined as "the
study and prediction of maladaptive behaviors and processes across time (Lewis, 2000,
The specific aspects of mental health functioning that were assessed in this study
were mood symptoms (i.e., depressed, anxious, angry and irritable moods); somatic
symptoms due to anxiety (e.g., elevated heart rate and stomachache); and substance use
(alcohol and other drugs). Mental health can be conceptualized as the presence of
positive symptoms (e.g., high self-esteem); however, utilizing the above definition for
this study allows the results to have direct implications for the applied science of
psychiatric and mental-health nursing.
This construct was operationalized with The Massachusetts Youth Screening
Instrument-Second Version (MAYSI-2; Grisso, Barnum, Famularo, & Kinscherff, 1998).
Four types of adverse mental health outcomes were measured. These were each measured
with a specific subscale of the MAYSI-2. The subscales included three mood-related
measures and one measure related to substance use. These were the four subscales used:
1. Depressed-anxious mood (8 items)-experiences of a mixture of depressed and
2. Somatic complaints due to anxiety (6 items)-experiences of bodily symptoms
associated with anxiety.
3. Angry-irritable mood (9 items)-experiences of frustration, anger, and
4. Alcohol and other drug use (8 items)-patterns of use of alcohol or drugs
(Grisso & Barnum, 2000).
Ethnic identity can be viewed as a "general phenomenon" that is relevant to all
ethnic groups. Different ethnic groups can have various belief systems, cultural practices,
even languages. However, it is the group identity or the "sense of identification with, or
belonging to, one's own (ethnic) group" that applies to all groups (Phinney, 1992, p.
158). This construct includes exploration/search and affirmation/belonging (Roberts et
al., 1999). The exploration factor is the "developmental and cognitive component" (J. S.
Phinney, personal communication, November 13, 2001). It includes searching for
information related to one's ethnicity and participation and involvement in ethnic and
cultural activities (Roberts et al., 1999). The affirmation and belonging factors are the
"affective components," (J. S. Phinney, personal communication, November 13, 2001).
This includes ethnic pride, a positive feeling about one's group, and a commitment to
that group. It also includes a feeling of belonging and attachment to one's ethnic group
(Roberts et al., 1999).
The Multigroup Ethnic Identity Measure (MEIM) was used as a measure of ethnic
identity (Phinney, 1992; Roberts et al., 1999; J. S. Phinney, personal communication,
November 13, 2001). This likert scale consists of 12 items. Responses range from
Strongly Disagree (1) to Strongly Agree (5). Higher scores indicate a more achieved
sense of ethnic identity.
A mentor is defined as a nonparental adult who has a trusting relationship with
the adolescent (Rhodes & Davis, 1996). According to the Oxford dictionary, a mentor is
defined as "an experienced and trusted advisor" (Pearsall, 1999, p. 890). Naturally
occurring mentors can be relatives, teachers, community members, or other important
adults. They provide both role-modeling and emotional support (Grossman & Rhodes,
2002). Additional defining aspects of a mentor include relational factors. Adolescents
believe they can "count on" the adult, that the adult cares for them "deeply," inspires
them to do their best, and has influence over important decisions that adolescents make
(Rhodes & Davis, 1996, p. 216).
The presence of a natural mentor was operationalized with the following question
previously used by Rhodes and colleagues (1992, p. 449; Appendix A): "Other than your
parents or whoever raises you, is there an adult in your life (a mentor, or positive role
model) who you go to for support and guidance?"
Mentoring quality factors
Beyond the perception of the presence of a natural mentor, descriptive factors can
serve as a measure of quality of the mentoring relationship. Several factors have been
shown to influence the association between the presence of a mentor and positive
outcomes (Grossman & Rhodes, 2002; Grossman & Tierney, 1998). These factors have
been examined more in the mentoring program evaluation research than in the research
done on natural mentors. The duration of the relationship has been found to be important
in mentor-mentee matched relationships (Grossman & Rhodes, 2002). Brief (less than 6
months duration) relationships can actually have detrimental effects (Grossman &
Other factors have been less well studied. The frequency and duration of typical
contact may also be important to the quality and potential influence of the relationship.
The most extensively studied mentoring program, Big Brothers Big Sisters, sets
minimum levels of contact between their matched mentors and mentees (Grossman &
Tiemey, 1998). Mentors must spend a minimum of 3 to 4 hours with their mentees at
least two to four times per month. This program has demonstrated significant positive
mental health outcomes for its participants (Grossman & Tiemey, 1998).
The final quality factor that was addressed in this study is the amount of trust
adolescents have in their mentors and how much they confide in their mentors. These
aspects have been considered part of the definition of a mentoring relationship (Rhodes
et al., 1992). This includes how much the adolescents tell their mentor about good and/or
bad things that happen to them. It also addresses the adolescent's perception of how
much this individual influences their behavior.
A series of items were developed to operationally define the quality mentoring
relationship constructs (Woolard & Greig, 2001). These items included several ordinal
response items that assessed the duration of the relationship and the frequency and
duration of typical contact. Also, based on previous measures and definitions a
Trust/Confiding likert scale was developed (Appendix A; Institute of Behavioral Science,
1990 as cited in Centers for Disease Control and Prevention, 2002; Nakkula et al., 1990;
Rhodes et al. 1992). The Trust/Confiding scale included seven items with the following
response options: (a) "a little bit," (b) "somewhat," and (c) "very much." Questions
included items such as "How much do you feel you can count on this person to be there
for you?" A mean score was calculated to reflect the amount of trust or confidence an
adolescent perceives in reference to his or her mentor.
Responses from all of the items described were used to determine the quality of
the existing mentoring relationship. Minimum levels were determined based on previous
programmatic and empirical work. The following criteria were used as the minimum for
a quality relationship:
1. Duration of the relationship: those that indicate the relationship has lasted
longer then 6 months (Grossman & Rhodes, 2002).
2. Frequency of visits: those that indicate that they spend time with their mentor at
least weekly (Grossman & Tierney, 1998).
3. Length of visits: those that indicate that they spend at least 1 hour per visit with
their mentor (Grossman & Tierney, 1998).
4. Trust and confiding scale: those that scored at least a mean of 2.0 were
categorized as having a quality mentor.
Other aspects related to the characteristics of the mentor were also obtained.
These aspects included the ethnic match of the mentor. An ethnically matched mentor
(i.e., Ethnic Mentor) is a mentor that is of the same ethnic background as the adolescent.
This person meets the above definition of a mentor with the added condition of being an
ethnic match with the adolescent.
The gender and mutual community membership of the mentors were also
assessed. Also, the relationship that the mentor has to the adolescent (e.g., teacher,
minister, relative, etc.) was assessed. These characteristics were measured using a series
of categorical items developed by the principal investigator (Appendix A).
Research Aims and Hypotheses
Aim 1. Evaluate the relationship between the presence of a mentor and the mental health
functioning of the mentee.
This will provide information related to the existence of natural mentors (e.g.,
extended relatives, teachers, ministers) in the lives of adolescents. The mental health of
those with and without quality mentoring relationships also was examined. This
information is important because there have been very few surveys that have assessed the
presence of natural mentors in school samples or defined the nature and quality of these
relationships. The studies that have found a relationship between the presence of mentors
and the mental health of adolescents have been conducted with non-normative samples
(e.g., pregnant teens). Based on existing research findings (Rhodes et al., 1992; Rhodes,
Contreras, & Mangelsdorf, 1994; Zimmerman, Bingenheimer, & Notaro, 2002),
Hypothesis 1 was reached.
Hypothesis 1. Those adolescents that have a natural mentor have better mental health
functioning than those that do not have a mentor.
Aim 2. Examine the relationship between the ethnic identity of the adolescent and his
or her mental health functioning.
This will provide important new information about the association of ethnic
identity and general aspects of mental health functioning (i.e., mood disturbance and
substance use). Although some of these aspects of mental health have been studied,
results have been mixed. Existing research has demonstrated that there are differences in
the relationship of these variables between ethnic groups and that this construct is more
salient to ethnic minority group members (e.g., Phinney, 1992; Roberts et al., 1999).
Based on existing research findings (Roberts et al., 1999; Brook, Balka, Brook, Win, &
Gursen, 1998; Brook, Whiteman, Balka, Win, & Gursen, 1998; Scheier, Botvin, Diaz, &
Ifill-Williams, 1997), Hypothesis 2 was reached.
Hypothesis 2. There is a relationship between ethnic identity and mental health
functioning in minority adolescents.
Aim 3. Evaluate the potential moderating effect of an ethnic mentor on the relationship
between the ethnic identity of the mentee and his or her mental health
This will provide information that has not been specifically addressed in the
existing literature. Although ethnicity is assumed to be a critical factor in matching
mentors and mentees in youth development programs, this has not been extensively
studied. There has been research supporting the idea that those who are ethnically
matched in an adoption situation do have higher ethnic identity. Based on research from
the adoption literature (e.g., Andujo, 1988), Hypothesis 3 was reached.
Hypothesis 3: The presence of an ethnically matched mentor moderates the relationship
between ethnic identity and mental health outcomes in minority
This chapter has described the general background and main purpose of this
study. The conceptual and theoretical underpinnings for this research were also described
(see Figure 1-1 for Conceptual Model). Conceptual and operational definitions, specific
research aims, and hypotheses were detailed. Lastly, a synopsis of the background
evidence for the research hypotheses was provided along with each specific hypothesis.
Depressed- Somatic Angry-Irritable Alcohol/Drug Use
Figure 1-1. Conceptual model
REVIEW OF LITERATURE
This chapter is an integrative review of the relevant literature. Nursing relevance
and related mental health research in adolescents is detailed first. Second, literature that
examines various psychological and behavioral factors that have been associated with
ethnic identity is described. Lastly, mentoring literature is reviewed; including program
evaluation research and research focused on naturally occurring mentors.
Relevance to Nursing-Adolescent Mental Health
The discipline of nursing has a history of evaluating mental health issues across
the lifespan. Nurse researchers have also been involved in assessing developmental needs
of various groups and implementing prevention and intervention programs in response to
those needs. This study is unique within the field of nursing because there has been no
research examining the presence of natural mentors and ethnic identity in the period of
early adolescence. However, this study does join a growing body of literature that
addresses mental health functioning in minority adolescents (Doswell, Millor,
Thompson, & Braxter, 1998; Gall, Pagano, Desmond, Perrin, & Murphy, 2000; Guthrie
& Low, 2000; Guthrie, Young, Williams, Boyd, & Kintner, 2002; Long & Boik, 1993).
Nurse researchers have investigated adolescent substance use in multi-ethnic
samples (Long & Boik, 1993; Guthrie et al., 2002; Guthrie & Low, 2000;). Long and
Boik surveyed 625 multi-ethnic elementary and middle school students about their
alcohol use and various measures of beliefs and self-concept. The sample was followed
longitudinally. There were no significant differences in alcohol use between the Native
American, Hispanic or European American participants. However, church attendance,
prayer, academic achievement, and a stable adult in the home were all protective against
alcohol use. In contrast, negative attitudes about school and a poor self-concept were
associated with higher levels of alcohol use (Long & Boik,).
Other nurse researchers have examined specifically African American adolescent
females and have developed theoretical models to explain substance use and other
aspects of mental health (Doswell et al., 1998; Guthrie et al., 2002; Guthrie & Low,
2000). Guthrie and Low developed a theoretical framework that proposes that multiple
social factors (sexism, racism, ageism) influence adolescent's self-efficacy, which
mediates the use of substances. An aspect of this model was tested on a sample of 105
African American adolescent girls (Guthrie et al). The results indicated that experiences
of discrimination were related to cigarette smoking. This relationship was partially
mediated by daily hassles, a measure of stress (Guthrie, et al.). Other work with African
American female adolescents has evaluated the relationships between family contextual
factors, biological development and self-esteem. Specific findings included establishing
the relationship between early onset of menarche and poor global self-image
(Doswell et al.).
Less nursing research has focused on the externalizing behavior of violence or the
related mood symptoms (i.e., anger/irritability). An exception is a survey of 213 violent
and nonviolent adolescent girls (Smith and Thomas, 2000). The two groups were
compared on several measures. The violent girls had more generalized anger, while the
nonviolent girls were more likely to report being angry after specific events. Feeling
angry enough to hit someone was associated with higher levels of loneliness, somatic
symptoms of anger, and peer rejection (Smith & Thomas). This study highlights the
relevance of exploring the angry and irritable mood symptoms of adolescent girls.
Lamb and Puskar (1991) conducted a school-based survey of 69 high school
students in order to assess the base-line mental health needs of the school. Rates of
suicidality and depression were 16% and 14%, respectively. Measures of anger
expression and control were also given to the participants. Those who scored high on the
depression and suicidality measures were more likely to report high anger expression and
low anger control (Lamb & Puskar).
Nursing research has also examined causal models of the depression and
outcomes due to depression in early adolescents (Mahon & Yarcheski, 2001; Yarcheski
& Mahon, 2000). Utilizing large multi-ethnic samples of middle school students,
relationships between stress, state-anxiety, well-being, conflict, social support, and
depression were evaluated. Findings were that state-anxiety had a direct effect on
depression, while stress was found to have a direct and indirect effect on depression
(Yarcheski & Mahon). Outcomes of depression included direct effects on well-being,
conflict, and perceived social support (Mahon & Yarcheski).
Nurse researchers working in school-based settings have assessed general
psychosocial functioning of adolescents (Gall et al., 2000). In a predominately Hispanic
(62%) high school, 383 adolescents were screened for general psychosocial dysfunction.
Fourteen percent scored above a cutoff criterion to indicate those that may require
intervention. Females, teen-parents, and those with Medicaid insurance were more likely
to be above the cutoff. There was no difference between the ethnic groups. Those with
higher scores had higher rates of tardiness and absenteeism. The adolescents that were
referred for mental health treatment had decreases in their rates of tardiness and
absenteeism, while the other group did not (Gall et al.). This study demonstrates how
screening within a school-based health center by nurses can improve some academic
indicators for adolescents with adverse mental health symptoms.
These studies demonstrate the value of a nursing developmental perspective in
research evaluating mental health in minority adolescents. Nurse researchers have
examined predictors of substance use, anger, and violence (Guthrie et al., 2002; Long &
Boik, 1993; Smith & Thomas, 2000). They have also developed theoretical models to
explain substance use and depression in adolescents (Guthrie & Low, 2000; Yarcheski &
Mahon, 2000). School-based surveys and screening procedures have demonstrated the
usefulness of these methods for identifying adolescents suffering from adverse mental
health symptoms (Gall et al., 2000; Lamb & Puskar, 1991). These methods also provide
assessments of the scope of the problem of adverse mental health symptoms in multi-
ethnic adolescents. Together this work provides precedence for this type of research
within the field of nursing. The following sections detail research primarily from the
developmental psychological literature and lay the foundation for this study.
Adolescents are beginning to explore and formulate identities in several domains
of life. Choices adolescents make concerning their developing identities can have an
impact on long-range outcomes. For example, an adolescent may choose to become
someone who is sexually active, uses substances, or plays sports. Other aspects of
identity are ascribed, for example ethnicity. During adolescence, the cognitive and
affective aspects of ethnic identity are beginning to take shape.
In the following sections, research is reviewed that has evaluated the role of
ethnic identity during adolescence for adolescents from several ethnic groups. Special
emphasis is made on studies that have examined the ethnic identity development of
Hispanic and African American adolescents and how this construct relates to various
measures of mental health. Qualitative and quantitative research that evaluated the
developmental model of ethnic identity is presented. Research that relates ethnic identity
to several positive aspects of psychological development is reviewed. Also, research that
has conceptualized ethnic identity within a resiliency framework is described. Lastly,
research that has compared levels of ethnic identity to various mental and behavioral
problems is reviewed.
Ethnic Identity Development
The majority of the research on ethnic identity development has been done with
adolescents and adults. The concept of ethnic identity development prior to adolescence
has been discussed only as it relates to racial or ethnic socialization (e.g., Bowman &
Howard, 1985; Caughy, O'Campo, Randolph, & Nickerson, 2002; Rotheram & Phinney,
1987; Thornton, Chatters, Taylor, & Allen, 1990). Rotheram and Phinney (1987) defined
ethnic socialization as "the developmental processes by which children acquire the
behaviors, perceptions, values, and attitudes of an ethnic group, and come to see
themselves and others as members of such groups" (p. 11). This definition clearly links
ethnic socialization to the development of ethnic identity, the aspect of identity related to
ethnic group membership. Ethnic socialization practices and their long-term effects on
ethnic identity development, however, rarely have been studied.
Research with African American families has focused on the many facets of racial
socialization (Bowman & Howard, 1985; Caughy et al., 2002; Thornton et al., 1990). In
general, the majority of African American parents do provide some level of racial or
ethnic socialization. Developing racial or ethnic pride is only one part of this process.
Other aspects include spirituality, preparation for bias, promotion of cultural mistrust,
potential racial barriers, egalitarian values, aspects of heritage, traditional practices, and
general self-development (Bowman & Howard; Caughy et al.; Thornton et al.).
Racial socialization practices by parents has been linked to fewer behavioral
problems in preschool aged children (Caughy et al., 2002). Also, adolescents and young
adults who had exposure to racial socialization practices by their parents had increased
levels of personal efficacy and better academic achievement than those with no reported
history of racial socialization (Bowman & Howard, 1985). Ethnic or racial socialization
seems to be associated with positive outcomes. Caughy and colleagues held parental
involvement constant and still found that racial socialization practices were associated
with positive outcomes for children.
These parenting practices are probably closely related to later levels of ethnic
identity. However, other community, peer, and school influences become increasingly
important as children enter adolescence. Adolescents are faced with the task of exploring
and defining their identity in several domains. Ethnic identity has been relatively
understudied in comparison to other aspects of identity (e.g., academic, social, physical).
These aspects of identity have been conceptualized as universal. According to Cross
(1991), ethnic identity has been viewed as separate from the general aspects of identity,
as well as separate from one's state of mental health. The current state of the research in
adolescents, however, demonstrates the role ethnic identity plays in the lives of ethnic
minorities. It is not only central to the identity of many adolescents, but has been
associated with multiple measures of mental health functioning.
Qualitative research with a multi-ethnic (African American, Latino/a, Native
American, European American, and Asian) sample of middle and high school students
created the basis for much of the current literature in this area. Interview techniques were
used in a series of studies investigating the salience of this construct and the potential
existence of developmental phases of ethnic identity formation (Phinney, 1989; Phinney
& Chavira, 1992; Phinney & Tarver, 1988).
A sample of 48 black and white 8th graders were interviewed in an urban junior
high school and were asked open-ended questions about ethnic identity. Responses were
categorized into searching or exploring behavior and commitment to or ethnic identity
achievement (Phinney & Tarver, 1988). Over 30 of the participants were moderately high
in searching, and 29% were moderately high in commitment. There was a trend for more
searching in the African American female adolescents. The construct of ethnic identity
was less salient for the white adolescents. They were less likely to discuss their own
group membership and more likely to discuss relations with other groups (Phinney &
Tarver). This study suggests the salience of ethnic identity for black adolescents,
Additional qualitative research furthered the evidence for a developmental theory
of ethnic identity (Phinney, 1989; Phinney & Chavira, 1992). Phinney (1989) utilized
several existing developmental theories to code interview data from a sample of Asian,
African American, Hispanic, and European American 10th graders. Results indicated that
an adaptation of existing theories was needed to explain ethnic identity. A three-phase
theory was developed. Students were categorized into an unexamined, a moratorium
(exploring without commitment), or an achieved group. The European American
response could not be categorized (Phinney). This study provided some initial evidence
for a developmental theory of ethnic identity for minority adolescents.
Phinney and Chavira (1992) conducted a longitudinal study of 18 African
American, Hispanic, and Asian American high school students. These adolescents were
interviewed to determine their phase of ethnic identity development and then followed
into young adulthood. Most of those adolescents that were in the unexamined or
moratorium phases of development at baseline progressed to a higher phase over time.
Those that were in the achieved phase at baseline were also in the achieved phase at
follow-up (all except one). These findings provide some preliminary evidence for the
developmental progression of ethnic identity and a relatively stable end state of an
achieved ethnic identity (Phinney & Chavira).
Dubois, Swenson, Tevendale, and Hardesty (2002) found no significant
difference in levels of ethnic identity between the African American and European
children that were in 5th and 6th grade. However, participants in their study that were in
7th and 8th grade did differ. The African American students had significantly higher
ethnic identity than their European American classmates (DuBois, Burk-Braxton, et al.).
This suggests that ethnic identity may increase over time, particularly for ethnic
minorities. Phinney, Ferguson, and Tate (1997) compared 547 8th and 11th graders and
found higher levels of ethnic identity in high school students than middle school students.
This work provides additional evidence for the theory of ethnic identity development
across the span of adolescence.
The following sections review literature on ethnic identity and various aspects of
mental health functioning. The majority of the research in the following sections has
assessed the overall level of ethnic identity. Exceptions are highlighted, as are the
specific aspects of ethnic identity that were assessed in the various studies. Unless
otherwise noted, the term ethnic identity refers to the overall level of ethnic identity
achievement for the adolescent.
Ethnic Identity and Positive Mental Health Functioning
The majority of research that has measured ethnic identity in adolescents has
compared this construct to positive aspects of mental health and psychological
functioning. The most commonly studied construct has been self-esteem (See Phinney,
1991 for a review). Other research has compared ethnic identity levels to aspects of self-
concept, self-efficacy, and academic achievement (Beale Spencer, Noll, Stoltzfus, &
Harpalani, 2001; Phinney, 1992; Phinney & Chavira, 1992; Smith, Walker, Fields,
Brookins, & Seay, 1999;). Effective coping styles and culturally based coping have also
been associated with ethnic identity (Constantine, Donnelly, & Myers, 2002; McMahon
& Watts, 2002; Phinney & Chavira, 1995)
Research connecting ethnic identity and self-esteem, has consistently found a
positive relationship (Phinney, 1992; Phinney & Chavira, 1992). Ethnic identity was
positively correlated with self-esteem in the minority participants of a sample of 417 high
school and 136 college students. This was not found in the white students, with one
exception. Ethnic identity was associated with self-esteem for the white students that
were the minority within their school (Phinney, 1992). This demonstrates that self-esteem
is related to ethnic identity for those with minority status and that the relevance of this
status may be contextual. In other words, minority status in one setting may make ethnic
identity salient in that context despite majority status in the larger social context.
Ethnic identity was also positively related to self-esteem levels longitudinally in a
sample of African American and Hispanic high school students that were followed into
young adulthood (Phinney & Chavira, 1992). Those with an achieved ethnic identity had
higher self-esteem at both baseline and follow-up. Interestingly, self-esteem was found to
be relatively consistent over time (self-esteem at baseline and follow-up were highly
correlated), while ethnic identity underwent developmental progression (phase of ethnic
identity development at baseline was not related to phase at follow-up; Phinney &
In a sample of 5,423 Mexican American, African American, and European
American early adolescents, ethnic identity was associated with increased levels of
coping, general mastery, self-esteem, and optimism (Roberts et al., 1999). Aspects of this
result were confirmed in a sample of 100 6th grade African American students (Smith et
al., 1999). Ethnic identity was linked directly and indirectly self-concept and self-
efficacy (Smith et al., 1999). Ethnic identity was directly related to general mastery,
emotional well-being, as well as peer and familial aspects of self-concept. It was also
positively correlated with perceived self-efficacy in the academic and career domains.
Interestingly, ethnic identity had a direct negative effect on prosocial attitudes (i.e., use of
legitimate methods for goal attainment). This finding was offset by the indirect effect
ethnic identity had on prosocial attitudes via self-efficacy (Smith et al.).
Some research that has supported the notion of differential effects over the course
of ethnic identity development has been in the area of academic achievement (Beale
Spencer et al., 2001). Academic achievement is a somewhat distal outcome variable in
comparison to self-esteem. However, this is an important area of functioning during
Beale Spencer and colleagues (2001) evaluated a sample of 562 African
American middle-school students, 80% to 90% of which were receiving free lunch. In
this study, standardized test rankings were used to operationalize academic achievement.
Four stages of racial identity were described: Eurocentric (unexamined acceptance of the
majority culture), transitional, reactive Afrocentrism (an early exploration of an
Afrocentric identity, considered "superficial" identification by the author), and proactive
Afrocentrism (the achieved, secure sense of racial identity; Beale Spencer et al., p. 26).
Although these terms are specific to African Americans and differ from those described
in the ethnic identity research, the findings are still relevant to the proposed research.
The Eurocentric (unexamined) and the reactive Afrocentrism
(exploration/searching) phases were associated with significantly lower levels of
academic achievement. In contrast, the proactive Afrocentrism (achieved) phase of racial
identity development was positively associated with academic achievement (Beale
Spencer et al., 2001). These findings suggest that certain phases of ethnic identity
development may be a vulnerable time for adolescents, but that an achieved ethnic
identity is associated with adequate functioning within the academic domain.
The relationship between ethnic identity and coping style within intergroup
relationships was examined in a study of 60 multi-ethnic parent-adolescent dyads
(Phinney & Chavira, 1995). Ethnic socialization, ethnic identity and coping styles in the
face of prejudice and stereotypes were studied. Findings were that those high school
students with high levels of ethnic identity were more likely to have proactive coping
styles. They were more likely to use discussion, self-affirmation, and attempts to
disprove stereotypes than to utilize passive or aggressive coping styles (Phinney &
Chavira). This suggests that ethnic identity has a positive effect on the ability to cope
with the stress of prejudice.
McMahon and Watts (2002) found that higher ethnic identity was associated with
an active coping style in a predominately African American early adolescent sample.
This coping style included direct problem-solving, seeking understanding, and positive
cognitive restructuring (McMahon & Watts). Constantine and colleagues (2002) found
that public self-esteem and the importance of collective self-esteem (defined similarity to
ethnic identity) were associated with culturally specific coping behaviors or Africultural
coping styles. In a sample of 106 African American adolescents, public self-esteem (or
how one believes their group is viewed by others) was associated with more use of
spiritually-centered coping. Greater importance of collective self-esteem was associated
with more collective coping (Constantine et al.).
These studies provide significant evidence for the positive nature of ethnic
identity development. Its association with positive psychological constructs (e.g., self-
esteem, effective coping styles, self-efficacy) places it in the realm of healthy or adaptive
development for those with minority status. Ethnic identity can be viewed as an aspect of
self-concept that develops in psychologically healthy individuals. That is not to say that
each individual requires the same level of this factor. It is only to say that a secure sense
of oneself as an ethnic group member is a positive aspect of self-concept.
Resiliency Models of Ethnic Identity
The broad conceptual framework of risk and resiliency has been utilized within
the disciplines of developmental psychology, medicine and nursing (Mandleco & Peery,
2000; Resnick, 2000; Werner, 1986). This framework is simple in that there are two
primary concepts, risk and resiliency. Risk factors are those factors (e.g., individual,
familial or social) that increase a person's chances of becoming ill? Resiliency factors are
those factors that increase a child's or adolescent's chances to complete healthy
development in the face of adversity or known risk factors (Garmezy, 1991; Werner,
1986). The finding that some individuals are able to avoid serious illness or behavioral
problems in spite of serious risk has led to a shift in the focus of research to the
identification of factors that promote resiliency.
A growing area of research has examined ethnic identity within the risk and
resiliency framework (Brook, Balka, et al., 1998; Brook, Whiteman, et al., 1998; Miller
& Macintosh, 1999; Scheier, Botvin, Diaz, & Ifill-Williams, 1997). These studies have
evaluated how protective ethnic identity achievement is against adverse mental health
Brook, Balka, and colleagues (1998) utilized several measures of ethnic identity
in a sample of 627 African American adolescents. African American awareness and
church attendance had a main effect on drug involvement. Those participants that
reported more African American awareness and that attended church regularly had lower
levels of drug involvement. The authors assessed risk and protective factors in multiple
domains (personality, family, peer, and ecological). Ethnic identity enhanced personality,
familial and peer protective factors. It protected against drug use in the face of
personality (i.e., depressive symptoms) and ecological risk factors, such as drug offering
strangers (Brook, Balka, et al.).
A similar study of 555 Puerto Rican adolescents found that ethnic identity
ameliorated several known risk factors for substance abuse and enhanced other protective
factors (Brook, Whiteman, et al., 1998). Spanish language preference and immigrant
status (as measures of ethnic identity) were both associated with lower levels of
substance abuse. In addition, several aspects of ethnic identity (e.g., affirmation and
belonging; familism; Hispanic awareness) were found to enhance resiliency or to be
protective against substance use (Brook, Whiteman, et al.).
A longitudinal study followed 1,303 7th graders into 8th grade (Scheier et al.,
1997). Risk factors were grouped into several domains (e.g., social skills risk like lack of
assertiveness). High ethnic identity was actually associated with high alcohol use in
African American and Hispanic adolescents. This association was especially strong in the
presence of cognitive-affective risk (e.g., knowledge and expectancies related to alcohol
use). In contrast, ethnic identity was protective against alcohol use in the presence of
social skills risk (e.g., assertiveness, communication, etc.). Ethnic identity was also
protective against marijuana use in the presence of social skills ands social influence risk
(e.g., perception of peer usage and availability of marijuana; Scheier et al.).
These findings, together, paint a complex picture about the relationship between
ethnic identity and substance use. Although some aspects of ethnic identity may be
protective against certain substances in certain individuals, many questions are still
unanswered. In some cases ethnic identity may even increase risk, specifically for
alcohol use (Scheier et al., 1997.
One study examined ethnic identity as a resiliency factor that potentially protects
adolescents in the domain of academic achievement (Miller & Macintosh, 1999). In a
sample of 131 African American adolescents that were at risk for academic failure,
ethnic identity was positively correlated with grade point average and inversely related to
school absenteeism. Ethnic identity also had a buffering or protective effect on academic
achievement in the presence of risk factors. Specifically, when the participants reported a
high amount of daily hassles, ethnic identity protected their level of academic
achievement (Miller & Macintosh).
Simmons and colleagues (2002) found that community-wide ethnic identity was
protective against depressive symptoms in the face of criminal victimization personally
or within the family. The association between criminal victimization and depressive
symptoms was larger for those early adolescents living in communities with lower ethnic
identity. This study did not specifically utilize a resiliency framework, but it was a multi-
community study that included 810 children and early adolescents (Simmons et al.)
This body of research provides an interesting framework for studying the
protective nature of ethnic identity in minority adolescents. However, due to the nature of
the resiliency framework, it is best suited for studying adolescents at risk for certain
problems (e.g., substance abuse or academic failure). The construct of ethnic identity
development is relevant to ethnic minority adolescents despite their risk status.
Ethnic Identity and Adverse Mental Health Outcomes
There is a growing body of literature that has examined ethnic identity and its
relationship to adverse mental health outcomes in school-based samples. Based on the
consistent finding that ethnic identity is directly related to positive mental health
functioning, researchers have begun to examine the question of its relationship to
negative outcomes. Findings have demonstrated that ethnic identity achievement has both
direct and indirect effects on adverse mental health outcomes depending on the
methodology utilized and the sample. The various findings related to this topic are
described here and contradictory results are discussed along with methodological issues.
Several studies have examined ethnic identity and levels of depressive and
anxious symptoms (Arroyo & Zigler, 1995; Caldwell, Zimmerman, Bernat, Sellers, &
Notaro, 2002; Dubois, Burk-Braxton, et al., 2002; McMahon & Watts, 2002; Roberts et
al., 1999; Rotheram-Borus, 1989; Simons et al., 2002). Research involving African
American and Puerto Rican high school students found differential relationships between
phases of ethnic identity development and internalizing and externalizing symptomology
(Rotheram-Borus). An achieved ethnic identity was associated with less self-destructive
behavior, but still was related to elevated levels of inattentiveness and nervousness.
Those adolescents in the moratorium phase of development (the period of
exploration/searching without commitment) were more likely to have internalizing and
externalizing symptoms (Rotheram-Borus). This study lends evidence to the idea that
exploration of ethnic identity may be a vulnerable time of development for adolescents,
while the achieved phase is protective against some adverse symptoms.
Findings related to mood symptoms and other internalizing symptoms have
differed among ethnic groups. Roberts and colleagues (1999) found that ethnic identity
was inversely related to depression and loneliness in a large sample of middle-school
students. However, this finding was only in African American middle-school students
and the effect sizes were very small. There was no significant relationship between ethnic
identity and internalizing symptoms in the Mexican American adolescents (Roberts et
In a sample of 91 African American high school students, high levels of
"racelessness," (identification with mainstream European American culture at the
expense of ethnic identification) was associated with more anxious and depressive
symptoms (Arroyo & Zigler, 1995, p. 904). In addition to racelessness, the researchers
also measured collective (ethnic) self-esteem. This construct was inversely related to
racelessness and also was positively related to self-efficacy (Arroyo & Zigler, 1995).
This research suggests that sacrificing one's ethnic identity is related to an increase in
anxiety and depressive symptoms.
McMahon and Watts (2002) found no relationship between ethnic identity and
depressive or anxious symptoms in a sample of 209 middle school students at high risk
for aggression. Simons and colleagues (2002) also found no association at the individual
level in a community sample of 810 African American early adolescents. However, when
community level ethnic identity scores were calculated, ethnic identity was related to
fewer depressive symptoms (Simmons et al.).
Other research has found indirect relationships between ethnic identity and
mental health outcomes (Caldwell et al., 2002; DuBois, Burk-Braxton, et al., 2002).
Ethnic identity was indirectly related to both emotional and behavioral problems via
global self-esteem in a sample of 350 black and white elementary and middle school
students (DuBois, Burk-Braxton, et al.). Racial Identity had an indirect effect on anxious
and depressive symptoms via perceived stress in a sample of 521 African American high
school students (Caldwell et al.). This latter study utilized a different conceptual
framework that assesses aspects of racial identity, mainly the private regard and
centrality of race (Sellers, Rowley, Chavous, Shelton, & Smith, 1997). Interestingly, the
private positive regard was inversely related to perceived stress, and the centrality of race
within the adolescents' self-concept was positively related to perceived stress.
There have been even fewer studies evaluating externalizing symptoms and ethnic
identity. No research has actually evaluated ethnic identity and angry/irritable mood in
early adolescents. However, attitudes about fighting and ethnic identity were evaluated in
a sample of 330 multi-ethnic middle-school students (Arbona, Jackson, McCoy, &
Blakely, 1999). The researchers controlled for two well-known risk factors for
aggression: lack of parental involvement and negative peer behaviors. Ethnic identity
was significantly related to non-fighting attitudes, in African American adolescents, but
not in Hispanics.
McMahon and Watts (2002) found a more achieved ethnic identity to be
associated with both less approval of aggressive behavior and less self-reported
aggression. This finding was in a sample of 209 predominately African American middle
school students from an urban, predominately low-income area. This finding contrasted
the finding that higher global self-esteem was associated with more self-reported
approval of aggressive behavior (McMahon & Watts).
Other research has examined ethnic identity and the externalizing symptom of
substance abuse. In a study of 127 11 to 20 year olds, there was a discussion about the
association between ethnic identity and high levels of substance abuse. However, this
actual statistical finding was not detailed in the article (James, Kim, & Armijo, 2000).
There were also differential findings between ethnic groups. The African American
adolescents had the highest level of ethnic identity, while there was no significant
difference between the Hispanics and European American adolescents (James et al.,
2000). The findings contradict the predicted direction of the relationship between ethnic
identity and substance abuse. They also demonstrate the need for research that examines
ethnic group differences.
The concept of ethnic identity has only been studied systematically in adolescents
over the last 10-15 years. It is clear from this research, that young people are examining
the meaning of their membership in ethnic minority groups. Adolescence is the logical
period of the lifespan to study aspects of identity formation (Erikson, 1968). Ethnic
identity has been consistently associated with positive aspects of psychological
functioning in adolescents. Research has demonstrated that ethnic identity can serve as a
resiliency factor in certain 'at risk' adolescents, protecting them from adverse outcomes.
Research measuring adverse mental health outcomes utilizing normative samples has had
the most mixed results and is the sparsest. More research is needed in this area, especially
research including Hispanic participants.
Most of the research examining mentors as a positive factor in children and
adolescent's lives has been in the area of program evaluation research. This research has
widely varying types of methodologies in part because programs also vary widely. There
is a growing body of research that has begun to examine naturally occurring relationships
between adolescents and mentors. The effect these relationships have on different mental
and behavioral problems is an understudied area. There have also been very few studies
that have systematically assessed factors that pertain to the quality of these relationships.
The exceptions are detailed in this review. Relevant program evaluation research is also
described in the following section. The work that has been done in the area of natural or
existing mentors is reviewed. A discussion of ethnic mentors and related research is also
Prevention research has indicated that broad based nonspecific prevention
programs are effective at providing basic developmental needs to at risk children and
adolescents (Grossman & Tierney, 1998; Tiemey, Grossman & Resch, 1995). Recent
research has demonstrated that relationships with mentors are developmentally normative
(Beam et al., 2002). Mentoring of youths by consistent caring adults provides a
developmentally necessary stable relationship for young people.
Mentoring is an intervention that has been gaining a lot of attention in recent
history. Mentoring, as a youth violence prevention strategy, was named one of four best
practices by the Centers for Disease Control along with family-based, home-visiting, and
social-cognitive strategies (CDC, 2000). The Search Institute (2002) named the presence
of a caring relationship with an adult as one of the key developmental assets for
One of the most scientifically rigorous program evaluations was done in
association with Big Brothers Big Sisters of America (Grossman & Tierney, 1998). Big
Brothers Big Sisters (BBBS) is the oldest and largest organized mentoring program in the
United States. The program is unique because of the extensive supervision of matched
youths and mentors by case managers. Mentors are thoroughly screened and trained prior
to any contact with the youths. Mentors are also required to have consistent, regular
contact for an extended period of time with the mentee.
A sample of 959 7 to 14 year olds was randomly assigned to community-based
mentoring or a wait-list comparison group (Grossman & Tiemey, 1998). Measures were
taken at baseline and after 18 months of mentoring. Participants in the experimental
group had increases in positive attitudes toward school and increased perceived trust in
their familial relationships. Girls had improved academic performance. Those that had a
mentor also had reductions in aggressive behavior, substance use initiation, and school
truancy (Grossman & Tiemey).
Rhodes, Grossman, and Resch (2000) also examined a mediation model using the
data from this longitudinal evaluation of BBBS. Mentoring was found to have significant
indirect effects on valuing school and academic achievement via improvements in
parental relationships. The authors theorized that the mentoring relationships might have
been corrective relationships that influenced the adolescents' working models about
relationships. In general, the relationships seemed to alleviate tensions in the parent-child
relationships, which was associated with school-related improvements (Rhodes et al.).
Grossman and Rhodes (2002) examined the duration of these mentoring
relationships. The participants were categorized into four groups based on the duration of
their relationship with their mentor and were evaluated on several outcome variables.
Those adolescents that had relationships that lasted longer than 12 months reported less
substance abuse and reported higher perceived self-worth, value of school, social
acceptance, and scholastic competence. They also reported better relationship quality
with their parents than those without a matched mentor. In contrast, those adolescents
that had relationships that lasted less than six months reported significantly more alcohol
use than the control group that received no mentoring (Grossman and Rhodes). The
implications for these findings are that long lasting mentor-mentee relationships can be a
positive influence on adolescents, while short lasting relationships may be damaging.
The duration of a matched mentoring relationship was also an important factor in
a program evaluation of a work-based mentoring program for African American high
school students (Linnehan, 2001). Out of 202 eligible students (GPA at least 2.0), 34
were matched with a mentor in the first part of the school year and 34 were matched in
the second half of the year. Those students that were matched for more than half the year
had better grades and attendance rates then those that did not participate at follow-up
Grossman and Rhodes (2002) also examined factors that might predict
relationship duration. Those matches with mentors that had higher incomes lasted longer,
but other mentor qualities did not consistently predict relationship duration. They found
that adolescents who had suffered abuse or were referred for psychological or educational
services were more likely to have a shorter relationship (Grossman & Rhodes). This is a
key point because mentoring programs are increasingly seen as a potential way to help
the adolescents at greatest risk for emotional and behavioral problems. Therapeutic
mentoring programs have been developed specifically to address this issue (Cavell &
Hughes, 2000 Jackson, 2002).
Undergraduate psychology students enrolled in a 15-hour per week practicum,
served as mentors for junior high school students with significant academic and
behavioral problems (Jackson, 2002). The mentees had declines in parent-reported
internalizing (depressed/anxious mood) and externalizing (behavioral) problems. They
did not show improvements in adaptive behaviors or teacher-reported problems.
However, other school related data was promising (i.e., reduced number of infractions).
This program is an innovative way to bridge mentoring and professional services.
However, the evaluation has methodological issues that plague much of the other
program evaluation research. Lack of controls within the field of program evaluation is
often a necessary reality.
The types of mentoring program implementation are as varied as the research
methodologies. Mentoring may take place in the community, in the school, or both.
Mentoring programs have been initiated for elementary school, middle school, and high
school students. Programs often include mentoring as one piece of a broader intervention.
This makes it difficult to differentiate effects of mentoring alone. However, researchers
have evaluated outcomes from aggression (Cavell & Hughes, 2000) to school attitudes
and classroom behavior (Dennison, 2000) to self-efficacy and future possible selves (Lee
& Cramond, 1999).
Cavell and Hughes (2000) found significant decreases in parent reported
aggression in a sample of 62 2nd and 3rd graders with behavior problems who had
school-based "therapeutic mentors" (p. 199). These mentors were not specifically
psychology students, but were provided with training specific to handling aggressive
children. The children with these mentors had better outcomes then those in the
"standard mentoring" group (Cavell & Hughes, p. 203). The mentors in the latter group
had no training or ongoing supervision.
Other research has found no significant improvement in classroom behavioral
functioning in 25 3rd and 4th graders evaluated in a pre-test post-test design (Dennison,
2000). These participants did, however, show academic improvement. They received an
in-school peer tutoring and mentoring program. It is difficult to tease out if the tutoring
was the key ingredient, or the mentoring, or both. Other mentoring programs, that do not
have a tutoring component, have also demonstrated an effect on academic achievement
(Blum & Jones, 1993; Grossman & Tiemey, 1998).
Blum and Jones (1993) found declines in the number of poor grades (Ds and Fs)
and increases in better grades (Bs and Cs) in a sample of 22 middle school students that
received mentoring from school personnel and a weekly peer support group. The
mentoring involved daily interaction between the mentor and mentee and occasional
planned recreational activities over 8-10 weeks.
Other programs that have yielded positive psychological outcomes have included
increases in levels of future aspirations (Lee & Cramond, 1999). A sample of 130 (78%
African American) elementary and middle school students that were mentored for more
than one year were compared to a wait-list group. The mentored group had higher levels
of future aspirations, but there were no differences in self-efficacy or future possible
Many of these studies utilized small sample sizes, lacked a comparison group, or
did not obtain baseline measurements on the dependent variables. This makes
interpretation of the findings difficult. However, some general conclusions can be made.
Mentors seem to help with aggressive behavior and substance use initiation (Cavell &
Hughes, 2000; Grossman & Tiemey, 1998). These relationships also seem to promote
positive attitudes about school and academic achievement, a primary area of functioning
for children and adolescents (Blum & Jones, 1993; Dennison, 2000; Grossman &
Tiemey, 1998). Longer mentoring relationships seem to be better then those of shorter
duration (Grossman & Rhodes, 2002; Linnehan, 2001) and therapeutic mentoring seems
to be effective for children and adolescents with behavioral problems (Cavell & Hughes,
2000; Jackson, 2002).
A recent meta-analysis of mentoring program evaluations utilized strict inclusion
and exclusion criteria (DuBois, Holloway, Valentine, & Cooper, 2002). Each study
included had to have utilized a comparison group or a pretest posttest design. The
average weighted effect size (d = .14) was interpreted to mean that, on average, those
with mentors did 55% better than those without mentors or had a 55% improvement over
baseline measurements. Outcomes included psychological, behavioral, academic, and
The authors also evaluated several moderating effects on outcomes. Effect sizes
did not vary between mentoring only programs and those that included mentoring along
with other interventions. Other factors that increased effect size included community
settings, structured activities, ongoing training for mentors, parental involvement, and
mentors with a background in a helping profession (e.g., teacher). The frequency of
contact with the mentor and the duration of the relationship were not moderators of effect
size. However, very few evaluations measured these variables. The type of outcome
variable did not moderate effect size, but the risk status of the youth did. Those youth
from economically disadvantaged backgrounds or that had other environmental risk
factors had more improvements than those that did not (DuBois, Holloway, et al., 2002).
Program evaluation research is often difficult to conduct with scientific rigor.
However, experimental designs and meta-analyses assist in truly evaluating which
interventions are effective for promoting healthy adolescent development. This review
details the existing research evaluating the effectiveness of mentoring programs. This
research provides evidence for the effectiveness of mentoring programs to have an
influence on several domains of functioning for children and adolescents. The following
section describes the literature related to natural mentors in the lives of adolescents.
The study of natural mentors is a relatively new area of research and there are
fewer studies than in the program evaluation literature. Interventionists are eager to
supply mentors without the assessment of existing supports in the natural environment.
The following literature addresses the existence of natural mentors in the lives of
adolescents at risk for emotional behavioral problems, as well as in more normative
samples of adolescents.
Early research on natural mentors by Rhodes and colleagues focused on African
American and Latino adolescent mothers (Rhodes et al., 1992, 1994). Only 35% of the
Latino female adolescent mothers had natural mentors (Rhodes et al, 1994). However, of
those that did, 95% had access to their mentors as often as weekly. The mentors tended to
be female (84.2%) and almost half of the adolescents had known their mentor for at least
16 years (46.4%). Those participants with supportive mentors had significantly less
anxiety and depression than those without mentors (Rhodes et al., 1994).
A descriptive study of 162 predominately Mexican American 10th graders found
that 78% had natural mentors (Sanchez & Reyes, 1999). The majority of these mentors
provided emotional support to their mentees (78%). This finding of almost double the
rate of the study with Latino teen mothers is striking. It could possibly demonstrate the
lack of a normative resource for the teen mothers. Other findings were similar between
the two samples. The school-based sample tended to have gender and ethnically matched
mentors. Seventy-one percent of the mentors were familial and another 23% were
informal (i.e., neighbor or friend). Almost half saw their mentor daily and 37% saw them
at least weekly.
Natural mentors were also protective against depression in African American
adolescent mothers (Rhodes et al., 1992). Of the sample of 129 14 to 22 year olds, those
that had a natural mentor had lower levels of depression than those who did not.
Interestingly, those young women with mentors also made better use of their social
support networks and accessed other support more readily.
In a sample of 770 high school freshmen, the existence of natural mentors and
several emotional and behavioral outcomes were measured (Zimmerman et al., 2002).
The sample was 79.6% African American and did not include those that were high
achieving (over 3.0 GPA) or those that had been diagnosed with emotional disturbances.
The findings were that 53.8% of the adolescents had a natural mentor. Those with a
mentor were less likely to smoke marijuana, had lower levels of violent and nonviolent
delinquency, and had more positive attitudes toward school.
Research on the protective quality of natural mentors for adolescents
experiencing stressful situations (i.e., pregnancy) has been expanded to examine the role
of natural mentors in normal adolescent development (Beam et al., 2002). In a sample of
243 multi-ethnic 11th graders in California, 82% reported having a natural mentor.
Approximately half were relatives and half were not. The researchers found that these
relationships were low in conflict and highly supportive. The adolescents received
support from their mentors as often as once or twice a week. These relationships served
different functions than either peer or parental relationships. The adolescents also tended
to obtain more support from their mentor if their relationship with their parents was high
Many of these studies have been done with African American samples; however,
the socioeconomic status (SES) of the participants is often confounded with ethnic
background (Hirsch, Mickus, & Boerger, 2002). Hirsch and colleagues demonstrated that
certain aspects of the adolescent mentor relationship are culturally specific and other
aspects are not. A sample of 122 African American and European American high school
students was asked to describe their relationships with an important grandparent and/or a
significant male adult (other than their father). African American adolescents were more
likely to name a natural mentor, either their maternal grandmother or an adult male
mentor. However, when SES was accounted for in the analysis, only the relationships
with grandmothers remained significant. Therefore, the African-American adolescents
were only more likely to name their grandmother as a natural mentor after SES was
accounted for in the analysis. This study demonstrates how certain types of mentoring
relationships are culturally defined, while others are related to economic factors.
The existence of natural mentors has been associated with less depressive
symptoms, less substance use, and lower rates of delinquency in adolescents (Rhodes et
al.,1992, 1994; Zimmerman et al., 2002). There is evidence to suggest that relationships
with natural mentors are a normative part of healthy adolescent development (Beam et
al., 2002). However, rates tend to vary widely across samples. Additional research is
needed to assess the existence and quality of these relationships. Clearly the relationships
between adolescents and naturally occurring mentors are different than those initiated by
intervention programs. Strengthening existing relationships with natural mentors may be
an additional way to intervene and enhance the lives of adolescents.
Another interesting question that has been studied minimally brings the area of
ethnic identity and mentoring together. The question of whether or not the ethnicity of a
natural mentor has an effect on the ethnic identity of the mentee has not been evaluated
extensively. This aspect of the research study will be somewhat exploratory. However,
there is some evidence to suggest that contact with same ethnic adults can influence
The construct of ethnic identity development has been studied in the foster parent
and adoption literature (Andujo, 1988; Friedlander, 1999; Friedlander et al., 2000).
Researchers have been interested in the development of ethnic identity in those children
and adolescents that are parented by adults with the same ethnic background compared to
those that are raised by parents with a different ethnic background.
One study included 60 families, 30 European American couples, and 30 Mexican
American couples that adopted Mexican American children (Andujo, 1988). Both groups
of adolescents (mean age 14 years old) had comparable levels of self-esteem after
approximately 5 years in the adoptive home. However, the ethnically matched families
had adolescents who were more likely to identify themselves as Mexican Americans and
had lower scores on a measure of acculturation. Also, the Mexican American parents
were more likely to socialize their children biculturally than the European American
Other researchers have utilized qualitative methods to examine the ethnic identity
of international adoptees (Friedlander, 1999). A study of 12 parents and 12 children and
adolescents utilized interviews and family drawings (as a measure of family relationships
and sense of belonging) to study ethnic identity development. Results indicated that all
but one of the participants were in the unexamined phase of ethnic identity. The
implications are that international cross-ethnic adoption may be related to a lack of
exploration of ethnic identity by the adoptee.
In a review of the research examining ethnic identity in internationally adopted
children, Friedlander and colleagues (2000) found that many cross-ethnically adopted
children are uncomfortable with their appearance and tend to have an Americanized
identity rather than a bicultural or achieved ethnic identity. These conclusions were
drawn from limited research and do not negate the findings that most of these children
and adolescents are fairly well adjusted (Friedlander et al., 2000). This population
(international adoptees) differs from ethnic minority group members born in the United
States. However, these findings provide some evidence that contact with those from the
same ethnic background can influence adolescent's ethnic identity development.
Rhodes and Reddy (2002) compared same-race to cross-race matches in the
longitudinal evaluation of BBBS. The results indicated that there were differences
between the groups. Mentees talked more about their problems with cross-race matches.
Also, parents perceived these relationships to improve peer relationships more than the
parents of those in same-race matches. However, girls in same-race matches had smaller
declines in the amount of value placed on school and self-worth. Boys in same-race
matches had smaller declines in school competence (Rhodes & Reddy, 2002). These
mixed results do not clearly indicate whether an ethnically matched mentor is, in total,
more beneficial for adolescents. The construct of ethnic identity was not evaluated in this
Mentoring programs typically do attempt to ethnically match mentors and
mentees. It is considered common sense that adolescents will be able to relate more
easily to an adult from the same ethnic background and that that person will be better
suited to serve as a role model and mentor. Natural mentors tend to be ethnically matched
(Sanchez & Reyes, 1999). However, the possible effect an ethnic mentor may have on
ethnic identity has not been studied. Research is needed to examine the potential
mechanisms by which an ethnic mentor may be beneficial for adolescents and their
mental health functioning.
Whether a caring adult is part of a program or is a family or community member,
these relationships seem to have the potential to promote healthy psychological
development. It may be that as adolescents mature, the support of a trusted adult, other
than a parent, becomes important. Although mentors seem to be a part of normative
development, descriptions of the quality of these relationships, the characteristics of the
mentor (e.g., community member, ethnic match) are factors that have only been
minimally studied. This clearly is an area that needs more research. Surveys can be
useful in assessing the availability of natural mentors and the quality of these
relationships for ethnic minority youth.
Adolescence is a time of growth, transition, and unfortunately risk for a variety of
mental health problems. There has been a large body of research examining various risk
factors for emotional and behavioral disturbance during adolescence. However, there has
been significantly less research examining issues that are specific to ethnic minority
group members. Ethnic identity and its relationship to mental health outcomes is one new
area of research that needs to be expanded. The mentoring literature is also under the
early stages of development. The existence of natural mentors and the roles they play in
the lives of adolescents are important research topics. Lastly, the question of how ethnic
mentors may influence ethnic identity and enhance mental health has yet to be answered.
Research is needed that examines the relationships between individual and social
factors and mental health outcomes in adolescents. This area of research has typically
neglected factors that have particular relevance to ethnic minorities. Discovering what
attributes or strengths may protect adolescents from emotional and behavioral problems
is also an understudied area of research.
The purpose of this study was to evaluate the relationships between ethnic
identity, mentorship, and adolescent mental health from a nursing perspective. The
Neuman Systems Model provided the framework for this study (Neuman, 1995). This
enables the findings to add to the body of knowledge within the applied field of nursing
science. The specific aims included: evaluating the relationship between ethnic identity
and adverse mental health outcomes, comparing the mental health of those that have a
mentor and those that do not, and examining the moderating effect of an ethnic mentor
on ethnic identity and adverse mental health outcomes.
This study utilized a cross-sectional, multi-site survey design. It was part of a
larger study that addressed several psychological constructs related to school violence.
The larger research study was entitled "National Middle-School Survey: School Violence
and Beliefs About Self, Others, and the Future" (Miller et al., 2001). The primary
purpose of the larger study was to develop a survey instrument that measures
psychological factors that have been or may be associated with aggressive and violent
behavior in early adolescents.
Aims of this study were to
S Explore the presence of reported natural mentors in the lives of adolescents,
define the quality of these relationships, and describe the general characteristics
of these mentors.
S Evaluate the relationship between the presence of a mentor and the mental health
functioning of the mentee.
* Evaluate the relationship between the presence of a quality mentoring relationship
and the mental health functioning of the mentee.
* Examine the relationship between the ethnic identity of the adolescent and his or
her mental health functioning.
S Evaluate the potential moderating effect of an ethnic mentor on the relationship
between ethnic identity of the mentee and his or her mental health functioning.
Related hypotheses include
Those adolescents who have natural mentors will have better mental health
functioning than those that do not have a mentor.
There is a relationship between ethnic identity and mental health functioning in
The presence of ethnically matched mentor moderates the relationship between
ethnic identity and mental health outcomes in minority adolescents.
The larger school violence study will, when concluded, include data from
approximately 25 public middle schools in four states (Florida, Texas, California, and
New Jersey). This study includes data from 14 schools in four counties, and two states
(Florida and California). The public schools included mainstream schools only. Testing
took place in classrooms, gymnasiums, cafeterias, libraries, and/or auditoriums as
dictated by the school personnel and administration. The entire survey took participants
between 45 minutes and 2 hours depending on the version of the survey administered and
the school. Research assistants were available to answer questions throughout the survey
Active parental consent, as required for Department of Education funded projects,
was obtained for all minor participants (Appendix B). A research team member
distributed permission slips to students after describing the research purpose and
procedures. Parents were provided the option of consenting or refusing participation for
their child. Failure to sign the informed consent form was considered a refusal. Research
assistants returned to the schools a second time to administer the survey. The survey was
given only to those students that returned a signed permission slip/informed consent
The current ethical standard is to obtain assent from participants that are at least
seven years of age (Vanderpool, 1996). A verbal assent form was read to potential
participants that had already returned a signed parental consent form (Appendix C).
Students were given the option to decline participation before the implementation of the
instrument. They were also told that they could stop participation at any time or leave
blank any questions they did not want to answer.
The survey was anonymous. Participants were instructed not to put any
identifying information on the survey. The participant's names were on the parental
informed consent forms. However, this information was kept confidential. All informed
consent forms and completed surveys were kept in locked filing cabinets in the research
lab at The University of Florida. There is no way to connect a specific survey to a
specific consent form.
Questions on the overall survey were related to a variety of sensitive issues from
victimization, aggressive behavior, and relationships with parents to adverse mental
health symptoms. For this reason, participants were told to contact the school counselor if
they felt upset or uncomfortable. The name of the school specific counselor was provided
in the verbal assent process. Because the research team cannot match individual
responses to specific participants, individual interventions were not implemented.
However, if a participant became visibly upset during the survey, he or she was referred
directly to the school specific counselor.
The sample includes all of the middle school students that completed the
measures specific to this study during their participation in the "The National Middle-
School Survey: School Violence and Beliefs About Self, Others, and the Future" (Miller
et al., 2001). Survey data were projected to be collected from 5000 middle-school students
in four states (Florida, California, Texas and New Jersey). Only the data from Florida and
California were completed at the time of this analysis. The measures of interest for this
study were removed from future testing plans. Therefore, this study includes data from
California and Florida only. A variety of geographic locations (e.g., rural vs. urban) were
surveyed. Nonprobability, purposive sampling procedures were used to obtain a sample
that is overrepresentative of African American and Hispanic adolescents.
Representative percentages vary based on which national statistics are utilized.
According to the 1999-2000 public elementary and secondary school enrollment statistics
released by the U.S. Department of Education (2002), 15.57% and 17.16% of students
are Hispanic and African American, respectively. According to the United States Census
Bureau (2000), 12.3% of the population are of Hispanic origin and 12.5% are black or
African American. These percentages are different due to the fact that more African
American and Hispanic families have children under the age of 18 years old (U.S. Census
Bureau, 2000) and these ethnic groups are over-represented in the public school system.
The following demographic data were included in the survey: age, sex, ethnicity,
socioeconomic status (SES), and single-parent household status. The racial and/or ethnic
background was assessed utilizing categories designed to accompany the Multigroup
Ethnic Identity Measure (Phinney, 1992).
Socioeconomic Status (SES) was assessed utilizing the Two Factor Index of
Social Position, developed by Hollingshead (1965). This is a widely used measure of
SES that asks the participants to report their parent's level of education and occupation.
These responses were categorized and weighted to calculate a score from 11-77. This
score can be used as a continuous variable or converted into social class categories
(Hollingshead, 1965). For this study the social class categories were used in the analyses.
This measure has been widely validated. The two-factor index is preferable with
adolescents, because they are usually unable to answer accurately the third factor,
Multigroup Ethnic Identity Measure
The Multigroup Ethnic Identity Measure (MEIM) was used to measure ethnic
identity. The MEIM was originally designed based on prior qualitative data (Phinney,
1992). The current version has 12 items that are scored on a likert scale from (1) strongly
disagree to (5) strongly agree. Higher scores indicated a more achieved ethnic identity
(J. S. Phinney, personal communication, November 13, 2001).
Results of an exploratory factor analysis with 200 middle school students
indicated two primary factors: (a) affirmation, belonging and commitment, and
(b) exploration and behaviors (Roberts et al., 1999). The correlations between these two
factors ranged from 0.70-0.75. This provides evidence that both factors are part of one
overarching construct and that the questionnaire can be used as a single measure of
ethnic identity. The factorial structure was weaker for the European American students.
Roberts and colleagues (1999) conducted the most recent and relevant study that
provided evidence of reliability and validity for early adolescents. They surveyed 5,423
middle-school students from several ethnic backgrounds. Cronbach's alpha was between
0.81-0.89 across ethnic groups for the 12-item survey. The MEIM was positively
correlated with coping (r=.23, p<.001), general mastery (r=. 19, p<.001), self-esteem
(r=.20, p<.001), and optimism (r=. 19, p<.001). It was inversely associated with
loneliness (r=-.09, p<.001), and depression (r=-.09, p<.001). The strongest relationship
that helped to provide validation for this measure was the relationship between the
MEIM scores and the salience of ethnic identity (r=.48, p<.001). Although these
correlations are low to moderate, they help to provide evidence for convergent and
divergent validation of the MEIM.
The first question used to assess the presence of a mentor was "Other than your
parents or whoever raises you, is there an adult in your life (a mentor or positive role-
model) who you go to for support and guidance?" (Rhodes et al., 1992, p. 449). This
question was developed based on the theoretical work of Levinson and colleagues
(Levinson, Darrow, Klein, Levinson, & McKee, 1978, as cited in Rhodes et al., 1992). It
has been used in previous research to assess the presence of a natural mentor (Rhodes et
al. 1992; 1994). This question has a "yes" or "no" dichotomous response. If the
participants answered, "yes" to this question, then they answered follow-up questions
relating to mentoring relationship quality and mentor characteristics. These items were
used to distinguish between the simple presence of someone perceived as a mentor and
the presence of a "quality" mentoring relationship.
Theorists and researchers alike have differing definitions of mentoring
relationship quality. There is also not a consistent way to measure this construct.
Previous researchers have asked individual items related to a mentor-mentee relationship,
however, there is not an existing measure of relationship quality that has been tested for
reliability and validity. For this reason, the Principal Investigator and other members of
the research team used existing research and theoretical literature on mentoring, to
develop a series of questions pertaining to mentoring relationship quality.
These questions related to the duration of the relationship, the frequency of
contact with mentor, and the length of time spent on a typical visit. These items were
developed in order to assess the amount of time spent together, the consistency of
contact, and the duration of the relationship. Previous theoretical, applied, and empirical
literature were used to determine cutoff points for each aspect of relationship quality that
was used to define a quality mentoring relationship (Chapter 1). These items have ordinal
Previous research has found that arranged mentoring relationships that last less
then six months can have minimal beneficial and actually some detrimental effects on
adolescents (Grossman & Rhodes, 2002). For this reason, those adolescents that reported
at least a 6-month duration of relationship were categorized as having a quality mentor.
The aspects of the frequency of contact and the amount of time spent at each visit have
also not been specifically researched in reference to natural mentors. The baseline criteria
used by Big Brothers Big Sisters (BBBS) was used as a guideline for these factors.
Community-based mentors in BBBS are required to meet with their mentees at least 2-4
times per month and to spend approximately two to four hours at each visit (Grossman &
Tiemey, 1998). For this study, those participants that reported seeing their mentor at least
once per week and that spent at least one hour per visit with their mentor were
categorized as having a quality mentor.
The last factor used to determine the quality of the existing mentoring
relationship was the amount of trust the adolescent has in their mentor and the comfort
they have with confiding in their mentor. A scale comprised of seven questions was
developed based on previous definitions of mentors and other measures of social support
(Nakkula et al., 1990 & Institute of Behavioral Science, 1990, as cited in Centers for
Disease Control and Prevention, 2002; Rhodes et al. 1992; ). The reliability of this
subscale has not been previously tested. However, reliability coefficients are detailed for
the current study in Chapter 4. This construct has been specifically used to define a
mentoring relationship (Pearsall, 1999; Rhodes et al., 1992). The minimum level for this
factor is also described in Chapter 1.
Several specific characteristics of the mentors were assessed using categorical
response items. The ethnic match of the mentor and their gender were assessed. Also, the
relationship between the mentor and the mentee or who the mentor is in reference to the
adolescent (e.g., relative, teacher, minister, etc.) was ascertained. Lastly whether or not
they live in the adolescent's community was determined.
Mental Health Functioning
The Massachusetts Youth Screening Instrument-Second Version (MAYSI-2)
assesses several aspects of psychological symptoms (Grisso et al., 1998). The instrument
was originally developed to screen adolescents ages 12-17 who have entered the juvenile
justice system. The instrument has several subscales that assess different domains of
emotional and behavioral symptoms. As previously mentioned, four subscales
(depressed/anxious mood, somatic complaints due to anxiety, angry/irritable mood, and
alcohol/drug use) were utilized in this study. The items have true/false responses and one
point is given for a yes response and zero points are given for a no response. The
responses are summed and ranges of available scores are utilized to assess risk (Grisso &
The original development of this instrument involved 1,200 adolescents in the
juvenile justice system in Massachusetts. Additional studies have been conducted in
California, Washington, and several other states. These data were utilized to establish its
reliability and validity for this population. The established average alpha coefficient for
the entire measure was 0.75. The average test-retest correlation coefficient was 0.74.
Validity coefficients ranged from .40-.65 (depending on subscale) when subscales were
correlated with other standardized assessments of psychopathology (Grisso & Barnum,
2000). Recent research with the MAYSI-2 has included community samples of
adolescents (J. Woolard, personal communication, January 11,2001). This has provided
evidence for the reliability and validity of this instrument in normative samples of
This measure of adverse mental health outcomes was chosen for two primary
reasons. First, this measure assesses several domains of mental health functioning in
relatively few questions. The use of a brief measure is necessary in order to fit the time
constraints (a one class period survey) of the larger research project. Second, this
instrument has been used as a screening tool in the juvenile justice system. A brief
screening instrument may be useful in assessment of adverse mental health outcomes in a
school setting as well. This study provides additional validity and reliability for use with
a normative school sample.
The statistical computer program SPSS was utilized for data analysis. Descriptive
statistics (frequencies, means and standard deviations) were done as appropriate for all of
the demographic variables. Univariate analyses were done to examine differences
between groups on the variables of interest. Descriptive statistics were also used to
analyze the specific characteristics of the natural mentors. The statistical tests used for
the specific research hypotheses are described in Table 3-1. A secondary series of
Factorial MANOVAs were done to examine the relationship between the presence of a
mentor and adverse mental health outcomes and to test for interactions between
mentoring and gender, ethnicity, socioeconomic status, and single-parent status.
Power for the regression analyses was sufficient. At least 50 participants are
required per independent variable to ensure adequate power in multiple linear and
logistic regression (Tabachnik & Fidell, 1989; Wright, 1997). Previous research that has
examined the variables under study has yielded small effect sizes (Roberts et al., 1999;
Zimmerman et al., 2002). For example one study examined the presence or absence of a
natural mentor and adverse mental health outcomes (i.e., marijuana use) and
demonstrated that those adolescents that had a natural mentor had significantly lower use
[y = (4.71-3.90)/4.34 = 0.18] than those that did not have a mentor (Zimmerman et al.,
2002). A difference of this size would be considered clinically relevant on the outcome
measures for this study.
Table 3-1. Statistical analyses
Research Aims Hypotheses Analysis
I. Evaluate the I. Those adolescents who I. Multivariate Analysis of
relationship between have natural mentors Variance (MANOVA)
the presence of a have better mental
mentor and mental health functioning than
health functioning of those who do not have
the mentee. natural mentors.
II. Examine the II. There is a relationship II. Multiple Linear
relationship between between ethnic identity Regression & Logistic
the ethnic identity of and mental health Regression.
the adolescent and functioning in minority
his or her mental adolescents.
III. Evaluate the III. The presence of III. Multiple Linear
potential moderating ethnically matched Regression was used to
effect of an ethnic mentor moderates the test for a significant
mentor on ethnic relationship between interaction.
identity of the ethnic identity and
mentee and his or mental health
her mental health outcomes in minority
A simple analysis for a dichotomous predictor variable (natural mentor, yes or no)
and a continuous outcome variable (alcohol/drug use subscale) was utilized to estimate
sample size. Assuming an alpha (two-tailed) = .05, and a beta of 0.20 (power = 0.80),
how many participants are needed to demonstrate a 6.25% difference on the alcohol/drug
use subscale, a small effect size? Utilizing an estimated standardized effect size of 0.20
SD, approximately 197 participants are needed per group to avoid a Type II error with
80% power (Marks, 1999; Polit & Hungler, 1991). Observed power is provided in
Chapter 4. Power was adequate for some of the research questions, but not others. This
issue is discussed in Chapter 5.
Despite careful research design, there are several study limitations that should be
considered in reference to the interpretation of results. The limitations are as follows:
* The use of a nonrandomly selected sample can limit external validity of the research
findings. However, for this study a purposeful sampling procedure was utilized to
ensure a representative number of minority participants
* The use of active parental consent may introduce bias into sample selection and can
also limit the generalizability of the research findings (Anderman et al., 1995).
However, the Department of Education requires active parental consent for all of
their funded research studies.
* The use of cross-sectional and correlational design limits the ability to determine
cause and effect relationships. A longitudinal or quasi-experimental design is beyond
the scope and purpose of this study. The primary purpose of the larger study was to
develop a survey.
* The use of adolescent self-report measures as the only data source may limit the
accuracy of the findings. Peer nominations and parent or teacher reports can be
utilized to address this problem. However, in order to maintain anonymity and to
remain within the time and financial constraint of the study grant, self-report
methods were utilized.
* Any effects that are due to the ethnic background of the research team and data
collectors will not be accounted for in the research findings. Even though the
research team is multi-ethnic, some students may have exposure to only European
American, African American or Hispanic team members. This factor is not
accounted for in the data analysis and is therefore a study limitation.
* Lastly, due to time and financial constraints this survey was only available in
English. This may be a limitation because the English reading and writing skills of
the participants were not assessed. It is possible that there were difficulties with
comprehension in some of the Hispanic participants.
This chapter describes the study design and sample as well as the larger research
project. The sample is then described in terms of demographic characteristics and the
other variables of interest. Lastly, the results related to the research aims and specific
hypotheses are detailed.
This cross-sectional survey was part of a larger study of school violence. The
larger study was a pilot project for a national survey and had as one of its primary
objectives the testing and design of a survey instrument. The procedures included adding,
evaluating, and deleting instruments and specific items at different phases of the project
based on empirical, theoretical, and logistical factors. For this reason the instruments
specific to this study were utilized on a subset of the larger sample. In order to maximize
statistical power, data from all available participants were utilized for each statistical
Nonprobability, purposive sampling was used to obtain an overrepresentation of
Hispanic and African American participants. The school violence survey obtained a total
of 866 participants at the time of this analysis. Of those participants, 548 received the
primary outcome measure (MAYSI-2) and the measure of ethnic identity (MEIM). The
mentoring items and the MAYSI-2 were given to 429 participants. All of the participants
received every demographic variable item with the exception of the single-parent status
question. This item was given to a subset of 281 participants. Missing data rates varied
from 2.5 to 8 % on demographic items and from 11.31 to 19% on the independent and
One demographic measure did have a higher rate of missing data than those
reported above. This was the measure of socioeconomic status. This measure required the
respondent to report their parents' type of job and their parents' occupation. Many
participants said they did not know this information or left it blank. Another subset
responded to the occupation item with a response that was too vague to be accurately
coded. Consequently, this variable was only included in the secondary analyses.
For the primary research objectives, data were included in the analyses that
reached a certain level of completeness. For the MAYSI-2 the guidelines outlined in the
survey manual were used. These guidelines require that a minimum of approximately
70% of the items per subscale be complete (Grisso & Barnum, 2000). For the other
subscales, those who completed at least 80% of the items were included in the analysis.
This cutoff was used for the larger survey for those measures that did not prescribe any
set procedure for handling missing data.
Analyses for the primary research questions were done with and without an
adjustment for missing data. The method utilized to account for missing data was
replacement with group means for the MAYSI-2 subscales and the MEIM. The results
were the same for both sets of analyses. Therefore, only the analyses utilizing the
completed dataset are presented.
Demographics are presented for the sub-sample of 548 participants. The
geographic breakdown for this sample is presented in table 4.1.
Table 4-1. Sample breakdown by geographic location
Location (State, County) n % Description
Los Angeles 182 33.2 Metropolitan
Florida 366 66.8
Alachua 143 26.1 Urbanized
Dade 32 5.8 Metropolitan
Hamilton 191 34.9 Rural
Note: Census 2000; Definitions based on population density.
The other characteristics of the sample are listed in Table 4-2. The majority of the
sample was African American, European American or Hispanic. The remaining ethnic
groups (Asian, Native American, Multiracial and Other) were combined into one group
entitled "Other" for analysis purposes. The sample ranged in age from 10 to 15 years of
age with a mean age of 12.41 (SD = 0.96).
The socioeconomic status of the participants who could be categorized (n = 132)
had a mean of 3.72 (SD = 1.01) on a scale from 1 to 5 with lower numbers representing a
higher social class. The top two groups were combined because of the few (n = 2) in the
highest socioeconomic group. Another general descriptive factor related to economic
status is the percentage eligible for free or reduced lunch. The schools that participated in
this survey had rates of student eligibility for free and reduced lunch that ranged from
30% to 86%. The majority of the schools had rates of over 50% eligibility (California
Department of Education, 2002; Florida Department of Education, 2002).
Table 4-2. Sample breakdown by demographic characteristics
Characteristics n %
African American 163 29.7%
Hispanic 160 29.2%
European American 125 22.8%
Other 100 18.2%
Male 203 40.3%
Female 301 59.7%
6 153 28.1%
7 210 38.5%
8 182 33.4%
The subscales of the MAYSI-2 were significantly inter-correlated. See Table 4-3
for exact figures. The overall Cronbach's Alpha was 0.86. The Cronbach's Alphas for
each subscale are listed in Table 4-3. Reliability coefficients were acceptable and similar
to those obtained in previous studies using this measure (Grisso & Barnum, 2000).
Correlations and descriptive statistics were also similar to those reported in the scoring
manual. The exception was the difference in the alcohol/drug use subscale. The youths
from the juvenile justice system had a higher mean score on this measure as would be
expected (Grisso & Barnum, 2000).
Subgroups means were compared based on ethnicity, grade and gender using
univariate analysis of variance tests with multiple comparisons. Differences were found
only on the depressed/anxious mood subscale. Girls scored higher on this subscale than
boys [F (1, 434) = 7.76; p = .006] and European Americans scored lower than the other
three ethnic groups [F (3, 443) = 7.29; p < .004].
Table 4-3. Measures of adverse mental health outcomes
MAYSI-2 subscale ac Mean SD A/I D/A S/C A/D
Angry/irritable (A/I) .77 4.08 2.54 .61* .49* .30*
Depressed/anxious (D/A) .72 2.84 2.20 .45* .35*
Somatic complaints (S/C) .69 3.19 1.83 .16*
Alcohol/drug use (A/D) .79 .624 1.35
Out of 362 respondents, 76.2% (n = 276) reported the presence of a mentor. Of
the group with mentors, 75.3% (n = 204) reported an ethnic match with their mentor and
63.4% (n = 170) reported that they are both from the same community. Seventy-two
percent of the mentors were female (n = 186) and 28.5% were male (n = 74). The
mentors were a gender match for 75% (n = 180) of the total matches; 54.6% (n = 131)
were female matches and 20.4% (n = 49) were male matches. Table 4-4 details who the
mentors are in relationship to the mentee.
Table 4-4. Description of mentors
Relative Neighbor Teacher Coach Minister Other
n 150 20 18 7 6 63
% 56.8 7.6 6.8 2.7 2.3 23.9
Mentoring Quality Factors
The results thus far have pertained to the general perception of the presence of a
mentor. More specific aspects of these relationships were also assessed. A series of items
about the duration of the relationship, frequency of contact, typical length of visits, and
the amount trust the mentee has in their mentor were used to categorize those who
perceived the presence of a mentor and those who had a substantial and consistent or
The majority of the mentoring relationships was stable and consistent. Eighty-
three percent knew their mentors for more than one year, 45% saw them everyday, and
50% spent over four hours at a typical visit. The average amount of trust and confiding
the youths reported was also high (mean = 2.67; range 0 to 3).
The following cutoffs were developed to define a quality mentoring relationship:
* Frequency of visits: At least weekly,
* Length of visits: At least one hour,
* Duration of the relationship: Six months or longer,
* Trust and confiding subscale: Those that scored at least a mean of 2.0.
Descriptive information is provided in Table 4-5. These criteria allowed for the creation
of two new groups, those with a quality mentoring relationship (n = 144) and those
without (n = 163).
Table 4-5. Descriptive statistics for quality mentoring items
n (%) above cutoff n (%) under cutoff
Frequency of contact 214 (81.7) 48 (18.3)
Duration of typical contact 223 (85.4) 38 (14.6)
Duration of relationship 213 (90.6) 22 (9.4)
Trust and confiding subscale (c = .83) 238 (92.2) 20 (7.8)
Natural Mentors and Adolescent Mental Health
The research questions related to the presence of natural mentors, the presence of
quality mentoring relationships, and adolescent mental health were answered using two
Multivariate Analyses of Variance (MANOVAs). The statistical rationale for using
MANOVA included the significant correlations between dependent measures and the
desire to reduce the risk for Type I error by repeated univariate analyses (Weinfurt,
1997). This test is appropriate only if the dependent variables can be combined
theoretically which is the case in this study. Combing the four dependent variables
creates a general construct of adverse mental health symptoms.
The statistical assumptions for MANOVA include multivariate normality,
homogeneity of covariance matrices, linearity, and independence of observations
(Tabachnik & Fidell, 1989; Weinfurt, 1997). These assumptions were met with the
exception of the distribution of the alcohol/drug use subscale, which had a positively
skewed distribution. Several transformations were attempted without success. However,
this subscale was retained in the model because MANOVA is robust to skewed
distributions with sample sizes greater than 200 (Tabachnik & Fidell, 1989; Weinfurt,
1997). In addition, the central limit theorem is applicable to studies with at least 20
degrees of freedom in each cell. This theory states that the sampling distribution of
means approach normality even if the sample data does not (Tabachnik & Fidell, 1989).
Two MANOVAs were done; the results are in Table 4-6. The first test compared
those who reported the presence of a mentor and those who did not. Those with a natural
mentor had higher levels of adverse mental health outcomes than those without a mentor.
The observed power was 0.78. The first hypothesis was not supported.
Second, the participants who met all four of the quality factor cutoff points
described in the previous section were categorized as having a quality mentoring
relationship. The second MANOVA compared the adverse mental health outcomes of
those with a quality mentor to the rest of the adolescents. These two groups were not
different on the mental health outcomes. There was no significant difference between
these two groups. However, this analysis had an observed power of only 0.20.
Table 4-6. Results for presence of a mentor and quality mentor analyses
Mentor grouping Hotelling's T F df (b/w) p r2
Presence of a mentor .036 2.88 4/324 .023 .034
Quality mentor .009 .617 4/281 .651 .009
Is the relationship between the presence of a mentor and adverse mental health
outcomes different when gender, ethnicity, socioeconomic status, and single-parent status
are taken into account? These questions were addressed by the use of three Factorial
MANOVAs. These analyses tested for interaction effects between the presence of
mentors and various demographic variables. All of the demographic variables were not
included in one model, because of the relatively smaller availability of data assessing the
SES (n = 137) and single-parent (n = 281) statuses of the adolescent's household. The
following analyses were done: 2 (mentor) X 4 (ethnicity) X 2 (gender) MANOVA; 2
(mentor) X 2 (single-parent) MANOVA; 2 X 4 (SES) MANOVA. Results indicated that
there were no significant interactions between the mentoring factor and the SES or
single-parent status variables. There were also no two-way or three-way interactions
between mentoring, gender, and ethnicity.
The second major area of interest pertains to the construct of ethnic identity. The
basic information about this measure is presented in Table 4-7. The European American
participants scored significantly lower (p = .019) than the African Americans and those
categorized as Other (p = .017), but not the Hispanic participants. There was no
significant difference on this measure based on grade or gender.
Ethnic Identity and Adverse Mood Related Symptoms
Multiple regression and logistic regression were used to test the second
hypothesis: There is a relationship between ethnic identity and mental health functioning
in minority adolescents. The assumptions for linear regression include residual
homoscedasticity (i.e., equal variance of the dependent variable at each level of the
independent variable), normal distribution, and linearity. Also, all pertinent variables
must be included, and all irrelevant variables are excluded. Lastly, measures must be
reliable and observations must be independent (Licht, 1997). These assumptions were
met with the exception of linearity. Transformation of the data and/or use of a non-linear
model were not appropriate due to the large number of zero scores. However, multiple
regression is robust to the effects of violations of the error assumptions (Licht, 1997).
Table 4-7. Multigroup Ethnic Identity Measure by Ethnic Group
a Mean SD
African American .74 3.55 .61
European American .75 3.33 .53
Hispanic .83 3.47 .59
Other .85 3.59 .67
Three subscales of the MAYSI-2 (angry/irritable mood, depressed/anxious mood,
and somatic complaints due to anxiety) were summed to create one dependent variable (a
= 0.86). This variable was normally distributed. This sub-divides the general construct of
adverse mental health symptoms and creates two more specific constructs. The constructs
are mood related adverse mental health symptoms and substance use. The alcohol/drug
use measure was not normally distributed and this measure was analyzed separately
using logistic regression. The rationale for this separation is detailed in the following
Standard multiple regression was done with gender, ethnicity, ethnic identity, and
an interaction term predicting the sum of the three mood related symptoms. The
interaction term combined ethnic identity and ethnic minority status. The interaction term
tested the idea that the significant relationship between ethnic identity and mood related
symptoms existed for minority group members only. Gender and ethnicity were dummy
coded and four dichotomous variables were created (African American = 1, Hispanic = 1,
European American = 1; Female = 1). The final model had six predictors. The model was
not predictive of the outcome variable [F (6, 403) = 1.76; p = .106]. Ethnic identity
achievement was not predictive in minorities for this dependent variable. The second
hypothesis was not supported for mood related symptoms.
Ethnic Identity and Alcohol/Drug Use
The alcohol/drug use subscale was positively skewed with the majority of the
respondents (73.5%) scoring zero on this subscale. Multiple transformations were
unsuccessful in obtaining a normal distribution. Therefore, this measure was changed to a
dichotomous outcome variable (0/1). A score of one indicated a positive response to any
item. This subscale was then used as an outcome in a logistic regression analysis.
In logistic regression it is assumed not only that the dependent variable is
dichotomous, but also that the options are statistically independent, mutually exclusive,
and collectively exhaustive (Wright, 1997). Also, the model must be adequately specified
(includes all relevant predictors and excludes all irrelevant predictors), and the sample
size must be adequate. Logistic regression requires at least 50 participants per
independent variable (Wright, 1997). All of these assumptions were met in this case.
Multiple logistic regression was done with the same predictor variables used in
the multiple regression analysis. The results indicated that the overall model was
predictive of alcohol/drug use category membership [X2 (6, 399) = 14.44; p = .025].
Group membership was accurately predicted for 98.1% of the participants based on the
predictors in the model.
Upon further analysis, the primary predictor of category membership was gender
(B = .531, Wald's X2 = 5.18, p = .023). Forty-five percent of the boys were categorized
as having any problems due to alcohol/drug use and only 30% of the girls were. The rest
of the predictor variables (including the interaction term) did not provide a significant
contribution to the model. The second hypothesis was not supported for alcohol/drug use.
A second multiple logistic regression was done without the interaction term
included. The rationale for this test was to create a more parsimonious model to test the
independent contribution of ethnic identity to the prediction of alcohol/drug use category
for all ethnic groups. The overall model maintained its significance with no loss of
accuracy in categorization [X2 (5, 400) = 14.07; p = .015]. The individual predictor
statistics are presented in Table 4.8. This finding demonstrates that ethnic identity does
predict alcohol/drug use for all of the study participants, not simply the minority
adolescents. Those participants with higher ethnic identity scores were more likely to be
in the non-use group than those with lower scores. The mean ethnic identity score for
those in the nonuse group was 3.52. The mean for the use group was 3.33.
Table 4-8. Variable contributions to the prediction of alcohol/drug use category
Variable B SE Wald Sig.
African American -.290 .350 .689 .407
Hispanic .025 .355 .005 .943
European American .283 .364 .604 .437
Gender .526 .233 5.09 .024
MEIM Score* -.507 .202 6.32 .012
*MEIM = Multigroup Ethnic Identity Measure
Ethnic Mentors: Testing A Moderation Model
A series of multiple linear and logistic regressions were done to test the
moderation model. The predicted model is presented in Figure 4-1. Although no
significant results were demonstrated for the minority adolescents alone, the moderation
model was tested in this group and in the sample as a whole.
Figure 4-1. Ethnic mentors and ethnic identity: Moderation model
Two multiple linear regressions were done with gender, ethnicity, ethnic identity,
presence of an ethnic mentor (Y/N), and an interaction term as predictors. The interaction
term combined ethnic identity and the presence of an ethnic mentor. These results are in
Table 4-9. Neither of these models was significantly predictive of mood related
symptoms despite the addition of a new interaction variable. The interaction variables
also were not independently predictive.
Two multiple logistic regressions were done with the same predictor variables.
These results are also detailed in Table 4-9. These two models were significantly
predictive in both the minority adolescents and the sample as a whole. However, the
interaction term was not independently predictive of alcohol/drug use categorization.
In the entire sample gender was the only significantly predictive variable
(B = .773; X2 = 5.87; p = .015). In the minority sub-sample gender (B = .791, X2 = 4.93;
p = .026) and Ethnic Identity (B = -.708, X2 = 3.87; p = .049) were the variables that
provided the significant contributions to the outcome variable. Hypothesis 3 was not
supported based on these analyses.
Table 4-9. Results of regressions testing the moderation model
Model Sample Outcome df Test Value Sig.
Linear Minority Mood Sym. 6/188 F = .554 .766
Linear Min/Maj Mood Sym 7/237 F = .984 .443
Logistic Minority Alc/Drug 6/173 X2 = 16.12 .013
Logistic Min/Maj Alc/Drug 7/177 X2 = 19.68 .006
Min = Minority Group Membership
Maj = Majority Group Membership/European American Ethnicity
Sym = Symptoms
Alc = Alcohol
DISCUSSION AND RECOMMENDATIONS
This study has explored individual and socio-cultural variables and their
relationships to mental health functioning in early adolescents. These factors were
conceptualized as strengths or aspects of healthy psychological development. They were
examined for their relationship to adverse mental health symptoms. This chapter explores
the results of the study. Findings related to the mental health functioning of the sample
are presented and then the constructs of ethnic identity and mentoring are detailed
separately. Recommendations are made and future directions for this area of study are
listed. Lastly, the implications for nursing are described.
Adverse Mental Health Outcomes
The assessment of levels of adverse mental health outcomes in a multiethnic
sample provides information that in and of itself contributes to the research literature.
There were no significant differences between the ethnic groups with the exception of the
depressed/anxious mood subscale. The European American adolescents scored
significantly lower on this measure than the other three ethnic groups. There are many
factors that may explain this finding. Differences in levels of depressed/anxious
symptoms may be due to socioeconomic factors (Conger, Ge, Elder, Lorenz, & Simons,
1994) or increased stress related to racism and/or discrimination (Guthrie et al., 2002).
However, other studies using this measure have found no significant differences between
ethnic groups or different profiles (Grisso & Barnum, 2000).
The MAYSI-2 was designed "to identify those youths who are most seriously at
risk of mental and emotional disturbances" (Grisso and Barnum, 2000, p. 32). The
authors of this instrument provided "Caution" and "Warning" cutoff levels for scores on
each subscale. The caution level was defined as having "possible clinical significance,"
while the warning level indicates those adolescents with the greatest need for clinical
intervention (Grisso and Barnum, p. 27).
The mean levels for this study did not reach even cautionary levels except for the
somatic complaints due to anxiety subscale. Thirteen percent of this sample met the
warning level criteria for somatic complaints due to anxiety. Fourteen percent and 11%
respectively were in the warning range on the depression/anxiety and angry/irritable
subscales respectively. Less than 1% met the warning level for alcohol/drug use.
The results of the alcohol/drug use measure (over 50% with a score of zero)
indicate that this measure may not be an appropriate measure of substance use for this
age group in a school-based sample. This subscale measures frequent use of substances
and the potential for serious difficulties with substances (e.g., dependence). A more
appropriate measure for middle-school students might instead measure experimentation
or infrequent use. However, reports of any presence of problems due to substance use in
this age range may predict future difficulties in this domain. Longitudinal studies are
necessary to determine the significance of these findings.
The majority of adolescents reported the presence of a natural mentor. This
validates earlier findings that have found natural mentoring relationships to be a part of
normative development (Beam et al., 2002). The majority of the mentoring relationships
were stable and consistent. The adolescents also reported a fairly high level of trust in
their mentors and were comfortable confiding in them as well. Over half of the mentors
were relatives. This finding is consistent with prior research (Rhodes et al., 1992, 1994;
Beam et al., 2002).
Despite these general trends, when strict criteria were utilized to define quality
mentoring relationships, the sample size became quite a bit smaller. Fifty-five more
participant responses could not be used because of at least some missing data on the
quality factor items. There was no significant difference between those with a quality
mentoring relationship and the other adolescents. This finding has a high risk for a Type
II error because of the low observed power. Future research could answer this question
more confidently with a larger sample. Also, it is possible that the criteria were too strict
and excluded mentoring relationships that were potentially beneficial in some way.
Those adolescents who reported the presence of a natural mentor did not have
better mental health functioning than those without a mentor. In contrast, they had higher
levels of adverse mental health symptoms than those without the presence of a mentor.
Although, the effect size was small and may be of little clinical significance, there are
some possible explanations for this finding.
It is possible that adolescents experiencing adverse mental health symptoms may
seek out mentors to help them cope with these difficulties. The theory that mentors can
make up or compensate for problems that adolescents are experiencing is part of the basis
for mentoring programs and also for some of the research on natural mentors (Rhodes et
al., 1992, 1994). Beam and colleagues (2002) found that the presence of natural mentors
was normative and not indicative of problems. However, these adolescents did tend to
seek out support from their mentors when their relationship with their parents was high in
As previously mentioned, a large majority of participants in this study reported
the presence of a natural mentor. This group had higher rates of adverse mental health
symptoms. If having a natural mentor is normative, a logical follow-up question is "Is it
normative to have adverse mental health symptoms during early adolescence?" Early
theories of adolescent development stated that it was a period of turmoil, stress,
transition, and mood liability (Muuss, 1996). However, despite the common stereotypes,
modern theory and research have demonstrated that the majority of adolescents transition
quite well through this period of the lifespan (Lewinsohn et al., 1998). It is unclear what
the explanation is for this unexpected finding. Additional studies are needed to further
evaluate this finding and examine its clinical significance
Ethnic identity was not found to be predictive of mood related symptoms. This
finding is in contrast to some previous research (Arroyo & Zigler, 1995; Roberts et al.,
1999; Rotheram-Borus, 1989). Other studies have also found no direct links between
ethnic identity and adverse mood related symptoms (Caldwell et al., 2002; DuBois, Burk-
Braxton, et al., 2002). Some research has confirmed models that demonstrate an indirect
relationship between ethnic identity and mood related symptoms. Ethnic identity has
been related to mood symptoms via perceived stress (Caldwell et al., 2002) and global
self-worth (DuBois, Burk-Braxton, et al., 2002). These additional constructs were not
measured in this study, so it is impossible to confirm if such mechanisms were at work in
The developmental level of the participants in this study is also important to
consider. Ethnic identity increases over time and it is possible that many of the
participants in this study were still in a relatively early phase of this developmental
progression. DuBois and colleagues (DuBois, Burk-Braxton, et al., 2002) found no
significant differences between African American and European American children (5th
and 6th grades), but in early adolescents (7th and 8th grades) African Americans had
significantly higher ethnic identity. This change in only a matter of one to two years of
development may also play a role in the influence of ethnic identity to mood related
Research with high school students has demonstrated many of the previous
findings in this area (Arroyo & Zigler, 1995; Rotherman-Borus, 1989). It is possible that
the influence of ethnic identity on mental health does not manifest until further along the
developmental path. Previous research has demonstrated that early during the
development of ethnic identity (i.e., exploration and increasing ethnic awareness),
adolescents can actually have increases in anxiety and depression (Rotheram-Borus,
1989). Stages of development were not assessed in this study; rather a general measure of
level of ethnic identity achievement was measured. It is possible that these differences,
which were not detectable with the measurement technique used in this study, clouded
the accuracy of the findings.
Ethnic identity was negatively related to alcohol/drug use. This finding validates
previous studies that have found ethnic identity to be protective against substance use in
minority adolescents (Scheier et al., 1997; Brook, Balka, et al., 1998; Brook, Whiteman,
et al., 1998). However, the results from these studies were varied based on the type of
substance and the ethnic group.
This study measured the overall influence of ethnic identity on any difficulties
related to substance use and found it to be predictive. This finding was found for the
sample as a whole. It was not found specifically for the minority adolescents. There are
several possible reasons why this may have occurred. One possibility is the presence of
white-ethnics, those who strongly identify with their European country of origin.
Unfortunately, subgroups within the European American participants were not
specifically identified, and it is therefore not possible to determine if this may have
influenced the findings. Another factor, that was not directly assessed, was the possible
minority status of the European American adolescents in some of the schools. Phinney
(1992) found that ethnic identity was associated with self-esteem for white high school
students when they were the minority in the school. A final reason that could explain why
this construct predicted substance use for all of the adolescents could relate to self-
esteem. A positive self-concept could be partially reflected by higher scores on the ethnic
identity measure. This could be true since many of the items reflect positive attitudes
toward one's ethnic group membership.
The predicted moderation model including ethnic mentors and their influence on
the relationship between ethnic identity and mental health outcomes was not supported.
In reference to adverse mood symptoms, this was probably not supported due to the lack
of a significant relationship between ethnic identity and this outcome. However, this
model was also not supported when there was a significant relationship (i.e., prediction
of substance use). It is possible that ethnic mentors do have an effect on adolescents in
different domains (e.g., self-esteem). The practice of matching mentors and mentees
based on ethnicity, gender, and interests is still considered standard. Although, this
makes intuitive sense, more research is needed to explain the mechanism by which these
relationships may influence adolescents and in what domains.
Recommendations and Future Directions
The first area of recommendations is related to methodology. Nonrandom
sampling procedures limit the external validity of the findings. Future studies using
probability-sampling techniques could greatly increase the generalizability of findings.
The use of survey methods has several limitations, some of which are described in
Chapter 3. Additional research in this area could be supplemented with additional
informants (e.g., parents, teachers, mentors) to validate the reports of the adolescents.
Another methodological issue was the length of the survey. The survey, at its
longest, contained 338 items. It took participants between 45 minutes and 2 hours to
complete. Fatigue and attention span are serious issues. Many were unable to complete
the survey due to fatigue or, in some cases, time constraints set by the school.
Instruments toward the end of the survey had higher rates of missing data than those at
the beginning. Future surveys of this type could be improved by giving shorter versions
to subgroups of participants.
As previously mentioned, it might be beneficial to translate the questionnaire into
Spanish or other languages for new immigrants whose English language skills may be
less well developed than other participants. Other ethnic groups could be examined and
specific items could be added to assess the specific Hispanic heritage of the participants.
Also, specifically in reference to the mentoring items, interview techniques could be very
useful. Many participants had difficulty following the directions that asked them to
answer questions if they had a mentor and to leave blank if they did not. Difficulty with
instructions may have interfered with the accuracy of the responses.
A different measure of SES should be utilized in future studies due to the high
rates of missing data and the somewhat dated occupational coding scheme used for the
Hollingshead (1965). In addition, longitudinal research is the ideal way to study
developmental issues. Longitudinal research could examine ethnic identity development
across adolescence. Also, the formation of mentoring relationships, their quality and
duration as well as any influence they have on the adolescent's well-being could be
studied over time.
Continued research related to the presence of natural mentors is definitely needed.
This area would benefit from qualitative research that explores the nature and quality of
mentoring relationships. Qualitative research would also improve the construct validity
of measures that could benefit from further development and validation. Also, a large
portion of the adolescents categorized their mentors as "other." In order to assess who
these mentors are, open-ended interview or survey items are necessary. Philip and
Hendry (2002) interviewed adolescents in Scotland and found intriguing results in
response to questions about natural mentors. The adolescents indicated that individual
peers (or best friends), peer groups, and adult-teen groups were all contexts in which they
obtained mentoring support. More research of this type is needed.
Alternative or supplemental measures of ethnic identity could be utilized in future
studies. For example, the Hispanic participants did not score significantly differently
from the European American participants. However, Spanish language usage and level of
acculturation are aspects of ethnic identity that were not assessed. These specific issues
are not part of the MEIM, which is a generic measure that can be utilized for all ethnic
groups. More specific measures may be needed for certain subgroups. It is possible that
these factors are related to mental health. Also population divisions may even have to be
more specific (e.g., Cuban American) if the intent is to develop programs or to intervene
with specific sub-populations.
As described above, this study utilized a measure of alcohol/drug use that
assessed problems due to drinking or drugs. A measure of substance use that assesses
infrequent use or experimentation with substances may be more appropriate in future
research with this age group. There are large-scale studies that address these sorts of
substance use issues (e.g., Youth Risk Behavior Surveillance-Middle-School; CDC, 1998
as cited in Fetro et al., 2001) for this age group. However, these studies tend to focus
only on the problem behaviors rather than examining strengths factors. Future studies
could examine individual and socio-cultural strengths and their relationship to substance
experimentation in middle-school students.
Several future directions for research are described in the previous section. This
section addresses the direct implications to nursing practice, education, and research. One
goal of an applied science such as psychiatric mental-health nursing is to provide the
basis for interventions that promote mental health, prevent disease, and treat mental
health problems when indicated. Psychiatric-mental health nurses are increasingly
involved in school-based screenings for those in need of mental health services (Gall et
al., 2000; Lamb & Puskar, 1991). The results of this study demonstrate that a brief
screening instrument can identify adolescents who are suffering from mental health
problems. The adolescents who scored in the warning range of the MAYSI-2 could be
referred for intervention in school-based settings.
In terms of the direct applications of this research study to the field of nursing,
ethnic identity achievement was found to be negatively related to alcohol/drug use.
Aspects of self-concept, including ethnic identity could be assessed when intervening
with adolescents. Research focused on psychosocial strengths can provide nurses with the
tools to develop theoretically based interventions with empirical support. Individual or
group interventions could target issues related to ethnic identity development in young
Schools of nursing also have implemented holistic interventions that have
included mentoring adolescents (Scheuring, Hanna, & D'Aquila-Lloyd, 2000). Nursing
education typically includes learning about the development of nurse-client relationships.
Nursing students could potentially serve as mentors as well as health care providers. In
addition, school nurses can serve as collaborators with the increasing number of
school-based mentoring programs. School nurses can play an integral role in helping to
develop these programs and to ensure that factors such as consistency, adequate duration,
and relationship building are considered within these programs. Nursing education must
also integrate knowledge of factors that are pertinent to the well being of ethnic
minorities. Culturally sensitive health care includes an acknowledgement of differences.
These differences ideally should be viewed as strengths rather than liabilities. Nurses also
should learn how to tap into resources beyond the walls of the health care setting.
Adolescents can be encouraged to access the support provided by natural mentors in
times of difficulty. Holistic health care must include assessment of multiple domains of
functioning and attempts to develop or enhance existing resources.
Nurse researchers have studied multiple individual and social factors that are
associated with depressive and anxious symptoms (Mahon & Yarcheski, 2001; Yarcheski
& Mahon, 2000) and substance use (Long & Boik, 1993). Additional mood symptoms
were assessed in this study (i.e., angry/irritable mood and somatic complaints due to
anxiety). This expanded the body of knowledge to include the wide array of mood related
symptoms that can be experienced by early adolescents. This study adds to the existing
nursing literature by examining factors relate to ethnic group membership and how this
relates to adolescent mental health. An achieved ethnic identity was associated with less
risk for alcohol/drug use. This study also describes the prevalence and characteristics of
an important community resource: natural mentors.
For the next question, please circle 1 for YES or 2 for NO to answer whether that
question is true for you.
10. Other than your parents or whoever raises you,
is there an adult in your life (a mentor, or positive role model)
who you go to for support and guidance? 1 2
If you answered YES to question number 10, please answer the following questions
about this adult you go to for support or guidance.
If you answered NO to last question, please go on to page 15.
Teacher Coach Minister Other
11. Is this person a?
12. Is this person from the same
ethnic group that you are?
13. What is the person's gender?
14. Is this person from your community?
(Ex. lives in your neighborhood,
attends your church)
once per week
1 to 3 times
4 to 6 times
15. How many times each week
do you see this person?
1 hour 1 to 2 hours 3 to 4 hours
16. How long do you spend
together on a typical visit?
Thinking of the adult you go to for support or guidance, for the following items,
choose the number (1) for A little bit, the number (2) for Some, and the number (3) for
A lot that best describes your feelings about that adult. Circle the number you choose.
A little bit
17. How much do you feel you can count
on this person to be there for you?
18. If you needed some information or advice
about something, how likely is it that
you could talk with this person?
19. If you got an award or did something well,
how likely is it that you would tell this person?
20. If you were in trouble at home,
how likely is it that you would tell this person?
21. How much do you feel he or she believes
in and cares deeply about you?
22. How much do you feel that he or she
inspires you to do your best?
23. How much do you think that knowing him
or her has really affected what you do and
the choices you make?
Some A lot
24. How long have you
known this person?
(Centers for Disease Control and Prevention, 2002; Rhodes, Ebert, & Fischer, 1992;
Woolard & Greig, 2001)
Thinking of the adult you go to for support or guidance, for the next question, please
indicate the length of time you have known the person by choosing the number (1) for
Less than 3 months, the number (2) for 3 to 6 months, the number (3) for 6 to 12
months, and the number 4 for more than 12 months. Circle the number you choose.
PARENT INFORMED CONSENT
National Middle-School Survey: School Violence and Beliefs About Self, Others,
and the Future
Scott A. Miller
A research team from the University of Florida is currently conducting a project
at your child's school. The purpose of this letter is to explain the project and to ask your
permission for us to include your child in the testing.
The goal of our project is to develop and to test a survey for middle-school
students. The survey is intended to identify some of the important thoughts and concerns
and characteristics of the present generation of middle-school students. We believe that
the results will provide some new and valuable information about this age group for the
educators and policy makers who shape children's school experiences. Your child's
school is one of about 25 schools around the country at which we are administering the
The survey will be given in the regular classroom setting [or whatever setting
applies in the particular school], and it will take about an hour to complete [if pilot
testing reveals a different session length this wording will be adjusted accordingly]. The
questions will address a number of topics that are important in the lives of middle-school
students. Some will ask students to reflect about themselves-what they feel especially
satisfied or dissatisfied about, what their expectations are for the future. Others will ask
about the child's relations with the important people in his or her life. Still others will ask
about experiences at school, including possible worries or fears about bullying and
school violence. In each case, we have worked hard to make the questions as clear as
possible for students this age, and to try to ensure that none will be upsetting to the child.
An important point to note about the survey is that responses will be completely
anonymous and confidential. Students will not put their names on the response forms,
and there will be no information on the forms from which individual children could ever
be identified. This means that no one will ever know how particular children
responded-no one at your child's school, for example, and indeed none of us on the
research team. Our interest is in general patterns of response and in possible variations
across different groups (for example, boys compared with girls, or 6th graders compared
with 8th graders). We have no need ever to know particular children's names.
The fact that responses are confidential is something that we will explain carefully to the
children. We want the children to feel free to answer honestly-and we want to be sure
that no child is ever concerned that someone might know how he or she responded.
Please indicate on the attached form whether you are willing to have your child
participate in the survey. The form should be returned to the child's school. Children who
do not participate will be given an appropriate alternative activity by their teachers. There
will be no negative consequences of any sort for children who do not participate.
In addition to asking your permission we will be asking your child's permission.
Prior to administering the survey, the researcher will provide a general description of the
questions to be asked and will emphasize that children are free to decide not to take part
-either from the start or at any point after beginning the survey. Children will also be
told that they do not have to answer any question that they do not wish to answer. Again,
there will be no negative consequences for children who decide not to participate.
Children who decide not to participate [here we will describe whatever alternative
activity the teachers have decided is appropriate for nonparticipants].
Our work is supported by grant from the Department of Education's Fund for the
Improvement of Education program. This project has been approved by the University of
Florida's Committee for the Protection of Human Subjects. It has also been approved by
the principal of your child's school.
We hope that both you and your child will decide to help us with the project. We
believe that the results of the survey can provide valuable information about the thoughts
and concerns of today's middle-school students, information that may eventually help to
make the school experience a more rewarding one for all children. The greater the
number of students who participate, the more accurate and helpful the results will be.
If you have any questions about the project, please call or e-mail Scott Miller at
the number or address given below. [Note: When we test in states other than Florida we
will attempt to provide a local contact number.] Questions or concerns about your child's
rights as a research participant may be directed to the UFIRB office, University of
Florida, Box 112250, Gainesville, FL 32611, (352) 392-0433.
Scott A. Miller
Department of Psychology
University of Florida
Gainesville, FL 32611
352-392-0605, x 216 email@example.com
University of Florida-Middle-School Survey
I am willing to have my child participate in the project.
I do not wish to have my child participate in the project.
VERBAL PARTICIPANT ASSENT
National Middle-School Survey: School Violence and Beliefs About Self, Others, and the
Assent Script for Middle-School Participants
We're from the University of Florida and we're doing a project at your school.
The project is for students in middle school, and your principal and teachers have given
us permission to do it at School. We're hoping that you'll decide to help us out.
The way you can help us out is by answering some questions about
yourself-what you're like, how you feel or think about different things. The questions
are on this survey [tester holds up copy], and you answer them on your own without
anyone seeing your answers. We'll give out the survey here in a few minutes, and it
should take about an hour to finish [if pilot testing reveals a different session length this
wording will be adjusted accordingly].
We can't tell you in advance about all the questions on the survey, but we'll try to
give you some idea of what they're like. Some of them are about things about yourself
that you're happy or perhaps not so happy about-for example, what you feel you're
good at and what you feel you're not so good at. Some of them are about your relations
with other people-for example, how you feel about other kids, or about your teachers or
parents. And some of them are about things that sometimes worry kids at school-for
example, the problem of bullies or school violence. In each case, we just want to know
what you honestly think.
There are several things that are very important to understand before we start.
One is that you don't have to do this. You can decide not to do it before we even start. Or
if you start and decide you don't want to do it that's OK too. Nothing bad will happen to
you if you decide not to do the survey-for example, your teachers won't be mad or give
you bad grades. If you decide not to do it [Here, we will describe whatever alternative
activity the teachers have decided is appropriate for nonparticipants.]
Another thing that's important is that you don't have to answer any question that
you don't want to answer. If there's anything that you just don't want to think about or
don't want to give an answer to you can leave it out. Now, if there's ever simply
something that you don't understand you should raise your hand and ask us. We want
you to skip a question only if you really don't want to answer it.
One last thing is very important. All the answers you give on the survey will be
confidential. This means that no one will ever know how you answered. Your teachers
won't know, your parents won't know, and those of us doing the project won't know. We
won't know because you won't put your name on the survey. Also, all the copies of the
survey are the same, so no one can tell which one you got. Finally, when you're done you
drop your survey in this box, and when we take them out later we'll have no way to know
which one is yours. We set it up this way for a couple reasons. One is that what we're