Supporting Positive Mental Health in Asian Children and Adolescents

1
Supporting Positive Mental Health in Asian
Children and Adolescents
Presented at the International School
Psychologists Association 28th Annual Colloquium,
Hangzhou, China July 16, 2006
2
Overview

• Introduction
• The Child Adolescent Wellness Scales (CAWS)
• The Study
• Purpose of the study
• Method

3
Overview (continued)

• Results
• Thailand
• Taiwan
• Japan
• Korea
• Conclusions
• Recommendations

4
INTRODUCTION
5
Some Statistics

• Over 2.5 million children in the US are reported
  to have emotional or behavioral difficulties
  which
• Interferes in the development of positive
  interpersonal relationships and
• May negatively impact learning and educational
  achievement (National Institute of Health, 2002).
• Children from lower socio-economic status are
  also at risk for increased emotional or
  behavioral problems.
• Boys are more at risk than girls of developing
  emotional or behavioral difficulties.

Federal Interagency Forum on Child and Family
Statistics, 2005
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More Statistics

• In an average classroom of 20 children, there
  are most likely three children who are either
  victims or bullies.
• Sexually transmitted diseases are increasing in
  the 15 to 19 age group.
• For young people 15-24 years old, suicide is the
  third leading cause of death.
• And on, and on, and on

Crockett, 2002
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Summary of Statistics

• There is obviously a great need for mental health
  services for children, adolescents, and young
  adults, because nearly 90 of all literature and
  information is focused on deficit-related
  behaviors (Myers, 2000).
• Despite our efforts in remediation, youth have
  continued to exhibit social, emotional, and
  behavioral difficulties (Catalano, Berglund,
  Ryan, Lonczak, Hawkins, 1999).
• So, what can we do to help?

8
Promoting Mental Health

• Awareness that mental health is an important
  aspect in childrens development
• Idea of a buffering against pathology
• Achieving a balance between remediation and
  prevention strategies
• Increasing success in intervention programs
• Creating assessment tools to identify strengths
  and assets in children and adolescents

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CHILD AND ADOLESCENTWELLNESS SCALE (CAWS)
General Information Underpinnings CAWS Dimensions
10
General Information

• Current tools only provide information regarding
  the existence of pathology through symptoms
• Lack of tools to determine positive qualities of
  school-aged children
• Therefore, the Child and Adolescent Wellness
  Scale (CAWS) was created by Drs. Ellis Copeland
  and R. Brett Nelson (2004) to comprehensively
  assess psychological wellness across multiple
  domains

11
General Information (continued)

• Individual paper pencil survey
• 150 items using Likert-type response scale
• Not at all like me/strongly disagree (1 point)
• Unlike me/disagree (2 points)
• Like me/agree (3 points)
• Very much like me/strongly agree (4 points)
• Estimated time for completing survey 25 minutes

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General Information (continued)

• Potential uses
• Comprehensively assess psychological wellness
  across 10 domains
• Outcome measure for prevention or intervention
  programs and research
• Psychometric Properties
• Internal consistency gt .74 for all subtests
• 7 factor structure indicated

Molina, 2005 Nelson, Traughber, Copeland,
Molina, 2005
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Underpinnings

• Positive psychology
• Risk and resilience
• Prevention

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Underpinnings (continued)

• POSITIVE PSYCHOLOGY
• Emphasis is on building
• Strengths
• Virtues
• Competencies
• De-emphasizes
• Mental illness or disease model
• Negative emotions, cognitions, behaviors

Seligman Csikszentimihalyi, 2000
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Underpinnings (continued)

• POSITIVE PSYCHOLOGY
• Accentuation of positive traits
• Hope and optimism
• Creativity
• Wisdom
• Interpersonal Skills
• Purpose is to create a buffer against
• Mental illness
• Intensification of symptoms

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Underpinnings (continued)

• RISK AND RESILIENCE
• What is a risk?
• Adverse situations
• Environmental stressors
• Resilience is
• Adaptive coping skills
• Positive outcomes for difficulty situations
• Protective factors
• Individual attributes
• Family quality
• Other support systems

Luthar Zelazo, 2003 Masten Powell, 1998
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Underpinnings (continued)

• PREVENTION
• Remediation programs not fully effective
• Targeting mental and physical health problems in
  youth with social emotional interventions
• Potential effects including
• Improve quality of life
• Increase productivity, namely academic outcomes
  in youth
• Control, if not decrease rising health care costs

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CAWS Dimensions

• Through theory and research, the CAWS items
  attempt to
• Reflect various factors which protects against
  the onset of mental illness
• Traits found among happy, psychologically-healthy
  individuals

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CAWS Dimensions (continued)

• ADAPTABILITY
• Definition The ability to negotiate difficult
  situations and their preparedness for change
• Coping reactions to stress
• Cognitive
• Behavioral
• Cognitive Behavioral
• 15 items

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CAWS Dimensions (continued)

• CONNECTEDNESS
• Definition A perception of belonging to school,
  family, and community
• Influential predictor and prominent factor in
  psychological wellness
• 15 items

21
CAWS Dimensions (continued)

• CONSCIENTIOUSNESS
• Definition Higher order understanding or
  acceptance of personal choices as well as
  responsibility for actions
• One of five robust personality factors
• 17 items

22
CAWS Dimensions (continued)

• EMOTIONAL SELF-REGULATION
• Definition The ability to control your emotions
  instead of letting your emotions control you
• Contributes significantly to social competence
  and success
• 16 items

Eisenberg, Fabes, Guthrie, Reiser, 2002
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CAWS Dimensions (continued)

• EMPATHY
• Definition The capacity to correctly perceive
  other persons emotional state and to feel along
  with that person
• An important factor in positive development and
  resilience
• 12 items

Eisenberg, 2003
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CAWS Dimensions (continued)

• INITIATIVE
• Definition Envisioning the future and engaging
  in activities that will lend to successful
  outcomes when presented with a challenging task
• Motivation has been determined as a key factor in
  success over the lifespan
• 13 items

Larson, 2000
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CAWS Dimensions (continued)

• MINDFULNESS
• Definition The awareness of self and personal
  strengths and weaknesses
• Also plays a key role in creativity and
  flexibility in problem-solving
• A central principle in emotional intelligence
  theories
• 13 items

Goleman, 1995 Langer, 2002
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CAWS Dimensions (continued)

• OPTIMISM
• Definition Having hope for the future
• Influences attentiveness to risks and coping
  strategies for more positive outcomes when faced
  with adverse situations
• Strongly linked to physical health status
• 17 items

Aspinwall Brunhart, 1996 Carver Scheier,
2002
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CAWS Dimensions (continued)

• SELF-EFFICACY
• Definition The belief in your ability to
  accomplish a task and promoting a sense of
  adequacy and confidence
• Central factor in Banduras social cognitive
  theory
• Built on experience and understanding of causal
  relationships
• 16 items

Bandura, 1997 Maddux, 2002
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CAWS Dimensions (continued)

• SOCIAL COMPETENCE
• Definition Personal intuition and knowledge
  leading to successful interpersonal relationships
• Interdependent upon emotional self-regulation
• Strong predictor of resilience
• 16 items

Hart, Hofmann, Edelstein, Keller, 1997
Topping, Bremner, Holmes, 2000
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THE STUDY
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Purpose

• Validate translated versions of the CAWS
• Taiwanese
• Japanese
• Korean
• Examine positive psychology constructs across
  cultures
• Investigate cultural factors that may impact the
  various domains of psychological wellness

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Methods

• Each translated version was verified by three
  professionals
• The translated versions were given to students
  between the ages of 10 and 22
• Statistical analyses included
• T-test, ANOVA, multiple regression
• Reliability internal and test-retest
• Validity

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RESULTS
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Data From Thailand
Sample Size (N) 204
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Gender
35
Grade
36
Age
37
Means of CAWS Dimensions
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Data From Taiwan
Sample Size (N) 252
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Gender
40
Grade
41
Age
AGE
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Means of CAWS Dimensions
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Data From Japan
Sample Size (N) 177
44
Means of CAWS Dimensions
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Data From Korea
Sample Size (N) 537
46
Means of CAWS Dimensions
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Data From U.S.
Sample Size (N) 248
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Means of CAWS Dimensions
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Comparison of Means
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Conclusions

• All Asian perceptions were lower than the US
  normative group on the 10 dimensions (though not
  all were statistically lower).
• Consistent with recent research predicting
  happiness from the CAWS, all dimensions were
  significantly related, with Connectedness and
  Optimism having the strongest relationships.

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Group DiscussionRecommendations for promoting
mental healthin Asian children and adolescents
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About the Presenters

• R. Brett Nelson, Ph.D., NCSP is a licensed
  psychologist who works as a school psychologist
  and an adjunct faculty member for the University
  of Northern Colorado. Contact information
  brettn327_at_yahoo.com
• Cin-Ru Cindy Chen, Ph.D., is an assistant
  professor at Ta Hwa Institute of Technology in
  Taiwan.
• Lily Huang, Ed.D., has 30 years classroom
  experience as a special education master teacher.

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About the Presenters (continued)

• Leesa Huang, Ph.D., NCSP, is an assistant
  professor at California State University, Chico.
• Naoko Kodama, is a doctoral student in school
  psychology attending the University of Northern
  Colorado.
• Kyongboon Kwon, is a doctoral student in school
  psychology attending University of Georgia.