2.7 Contexto regional
2.7.1 Región Centro Oriente de Puebla
2.7.1.1 San Pablo Actipan
At baseline measures were taken of: annoyance, depression and anxiety and parent report of poor behaviour and child psychological well-being. At follow up repeat measures were taken of annoyance, depression and anxiety. Self-reported stress was measured for the first time at follow-up.
Baseline Measures
These measures were: annoyance, depression and anxiety, mood and parent report of deviant behaviour.
Annoyance
Noise annoyance was measured with 7 child adapted standard questions (Fields, 1992; 1997). These questions assessed the level of annoyance (very much, quite a bit, a little, not at all) felt by the child when they heard 4 sources o f environmental noise at home and school. The sources of environmental noise were: aircraft noise, train noise, road traffic and neighbours noise (only at home). Aircraft noise at school was the annoyance item used in the analyses. The higher the score the higher the noise annoyance (range 0 -3 ).
Depression
Depression was measured with the short version of the Child Depression Inventory (CDI; Kovacs & Beck, 1977, modified for an English sample, Charman, 1994). The CDI is the m ost widely used instrument to measure childhood depression in children from 8 - 1 6 years old (Kazdin, 1981). The CDI is a 14-item forced choice self-report inventory measuring depressed mood. The child is asked to indicate which of 3 descriptions best fits how they have been feeling over the past two weeks (e.g. ‘I am sad once in a while, I am quite often sad, I am sad all the tim e’). The items are drawn from the emotional, motivational, cognitive and somatic symptoms o f depression. It takes 10 minutes to complete. The scores range from 0 - 28 . The higher the score the greater the depressed mood. The short version of the CDI is just as sensitive as the longer version of the CDI (Personal communication Dr. Fundudis). The CDI has relatively high internal consistency and stability (Carlson and Cantwell, 1980; Finch et al., 1985; Fundudis et al., 1991; Helsel & Matson, 1984; Saylor et al., 1984; Smucker et al., 1986). The cut off score for a high rate of depression was 9 which was based on the score used in past studies (Carlson & Cantwell, 1980, Fundudis et al., 1991). This cut off has been used as a criterion for screening children with a depressive episode (Carlson & Cantwell, 1980).
Anxiety
Anxiety was measured with the Revised Child Manifest Anxiety Scale (CMAS; Reynolds & Richmond, 1978). The CMAS is a 28 item forced choice self report inventory of chronic anxiety reactions. The child is asked to indicate by answering yes or no whether a statement is generally true about themselves (e.g. ‘ You are afraid of a lot of things’ ). The scores range from 0 - 28. The higher the score the greater the anxiety. Included with this scale is a 9 item lie scale, with a range of 0 - 9.
The CMAS produced a high Kuder-Richardson reliability estimate of .85 in a cross validation study of the revised scale (Reynolds & Richardson; 1978). The cut off score for a high rate of anxiety was 17 which was based on the normative data reported in Reynolds & Richmond (1978). They reported a group mean on the anxiety scale of
13.84 with a standard deviation of 5.79. The cut off of 17 was selected because it was just more than half a deviation above the mean.
Modified Rutter Parent Questionnaire
The Modified Rutter Parent Questionnaire is an expanded version o f the Rutter A2 questionnaire (Rutter et al., 1970). The Revised scale contains 8 health items, 5 habit items and the 25 item Strength and Difficulties Questionnaire (SDQ). The Strength and Difficulties Questionnaire asks about 25 attributes, 10 o f which are considered strengths (e.g. ‘thinks things out before acting’), 14 of which are considered difficulties (e.g. ‘often unhappy, down-hearted or tearful’) and one of which is neutral ( ‘gets on better with adults than with other children’). Each item is marked as ‘not true’, ‘somewhat true’ or ‘certainly true’. This SDQ contains 5 sub-scales: hyperactivity scale, emotional symptoms scale, conduct problems scale, peer problems scale, prosocial scale. A total difficulties score can be calculated ranging from 0- 40. The Rutter Health and Habits section can be scored in the standard way to generate scores for probable disorder, conduct problems, emotional symptoms (Rutter, 1967, Rutter et al., 1970; Schachar, Rutter & Smith, 1981).
Scores derived from the parent SDQ and the Rutter Questionnaire were found to be highly related (total difficulties score r=0.88 ) (Goodman, 1997). Goodman, 1997 concluded that: ‘given the well-established validity and reliability of the Rutter questionnaires (Elander & Rutter, 1995), the high correlation between the total scores generated by the SDQ and the Rutter questionnaires is evidence for the concurrent validity of the SDQ’. The ROC analyses reported in Goodman (1997) indicated that the SDQ had equivalent predictive validity to the Rutter questionnaire. These results indicate that the revised questionnaire has equivalent predictive validity with the Rutter Questionnaire (Goodman, 1997). The modified version of the Rutter A2 was used because it has the advantage of focusing on children’s strengths as well as weaknesses which a) increases parent compliance and b) reduces possible halo effects. The total deviance score is a summation of hyperactivity, emotional, conduct and peer problems subscales. The higher the score the greater the total deviance.
Follow-up Measures
These measures were: annoyance (same as above), depression (same as above), anxiety (same as above) and self-reported stress.
Self-Reported Stress
Child stress was measured with the
child stress scale
(Lewis et al., 1984). The scale consists of 20 stress-provoking circumstances that were generated through interviews with children concerning sources of stress in their lives. The child stress scale was selected because it defines ‘stress’ from the child’s perspective and has been used in previous research with children (Lewis et al., 1984; Lewis & Lew is, 1985; Brown & Siegel, 1988). The 20 items included situations that would make children feel bad (e.g not having homework done on time), nervous (e.g changing schools) or worried (e.g not getting along with your teacher). The 20 items were repeated in two subscales. The first scale asks the children to rate how bad would they feel if each o f the 20 situations happened to them on a 5 point scale: ‘not bad’, ‘a little bad’, ‘pretty b ad ’, ‘very bad’,‘terrible’. The second scale asks the children to rate how often each of the 20 situations happened to them on a 5 point scale: ‘never’, ‘once or tw ice’, ‘som etim es’, ‘often’, ‘all the tim e’. Three scores were used in the analysis:
1) a perceived stress score:
asummation of the first scale how bad would they feel if an event happened to them,
2) a
frequency score:
a summation of the second scale to calculate how often negative life events had occurred,3) An overall stress score
is calculated by individuallymultiplying each item from the first scale ( ‘how bad they would feel’) by the second scale (frequency of occurrence) and summing the total for the 20 items.
Normative data from 2,480 5th grade American students found high internal
consistency (alpha=0.82). with the feel-bad score (Lewis et al., 1984). A principle components factor analysis on the same data set with varimax rotation yielded three factors of the scale are: 1) anxieties surrounding conflicts with parents, 2) self-image, self-esteem and peer-group relationships and 3) dislocations (changes in living arrangements) (Lewis et a l , 1984).