Mexican American Adolescents' Family Caregiving: Selection Effects and Longitudinal Associations With Adjustment

• Author: Patricia L. East,Thomas S. Weisner
• DOI: http://doi.org/10.1111/j.1741-3729.2009.00575.x
• Published date: 01 December 2009
• Date: 01 December 2009

PATRICIA L. EAST University of California, San Diego

THOMAS S. WEISNER University of California, Los Angeles*

Mexican American Adolescents’ Family

Caregiving: Selection Effects and Longitudinal

Associations With Adjustment

One hundred ten Mexican American adoles-

cents (12 – 17 years) who provide infant care

for their older sisters were studied to determine

the effects of family caregiving responsibili-

ties on adolescents’ adjustment. Controlling for

prior adjustment and family context factors, pro-

viding many hours of caregiving predicted an

increase in youths’ school absences and disci-

plinary problems. Frequent conflict surrounding

caregiving was associated with increased stress

and depression and lower school grades. Older

girls appear to select into caregiving and expe-

rience the most problematic outcomes. Strong

family obligations were not protective against

caregiving stress but, rather, further compro-

mised youths’ well-being for those who were

highly involved in their family’s care.

Understanding how family caregiving affects

youth is highly significant given that recent esti-

mates are that 1.4 million U.S. children and

Department of Pediatrics, Division of Child Development

and Community Health, University of California, San Diego,

La Jolla, CA 92093-0927 (peast@ucsd.edu).

*Department of Psychiatry, Center for Culture and Health,

University of California, Los Angeles, CA 90024-1759.

Key Words: family caregiving, family obligations, Mexican-

American adolescents, siblings of teenage parents, teenage

parents.

adolescents provide some type of care to a fam-

ily member (National Alliance for Caregiving,

2005). The ramifications of family caregiving for

adolescents’ development are not well under-

stood (East, in press). There is, however, an

emerging literature that is beginning to consider

how excessive family caretaking responsibilities

on the part of youth may affect developmental

outcomes (Burton, 2007; Dodson & Dickert,

2004). Indeed, large amounts of adolescents’

family caregiving (helping parents, grandpar-

ents, or siblings with daily living assistance

tasks such as bathing, dressing, and feeding

20 hours or more a week) have been found

to be associated with children’s stress, depres-

sion, and school absences (Pakenham, Bursnall,

Chiu, Cannon, & Okochi, 2006; Shifren &

Kachorek, 2003). Results of two large stud-

ies, one in the United States and one in the

United Kingdom, indicated that youth who care

for a family member experience significantly

more anxiety, antisocial behavior, and feelings

of low self-worth than noncaregivers of com-

parable age and racial background (Dearden &

Becker, 2000; National Alliance for Caregiving).

Within Great Britain, young caregivers missed

school significantly more often than other chil-

dren and reported feeling stressed and depressed

(Aldridge & Becker, 1993). In contrast, other

studies have suggested that youths’ family care

yields developmental benefits, such as matu-

rity, self-reliance, and empathy (Beach, 1997;

562 Family Relations 58 (December 2009): 562 – 577

Latino Adolescents’ Family Caregiving 563

Chase-Lansdale, Wakschlag, & Brooks-Gunn,

1995). Adolescents’ helpfulness in the home and

involvement in general family household tasks

have also been found to contribute to positive

self-esteem and feelings of interpersonal compe-

tence (Beach; Call, 1996; Kuperminc, Jurkovic,

& Casey, 2009).

In this study, we examined the relations

between Mexican American adolescents’ family

caregiving and their adjustment. As a form of

family care, we examined the caretaking youth

provide to their teenage sister’s infant. Infant

care provided by the siblings of a teenage parent

is a common and often necessary response and is

typically favored over other strategies because

it is convenient, affordable, and best utilizes

available family personnel (East, Weisner, &

Reyes, 2006; East, Weisner, & Slonim, in press).

Sibling-provided infant care is an important

issue for Latino families because Latinos

currently have the highest teenage birthrate of

any racial/ethnic group (Martin et al., 2009), and

most parenting Latina teens remain with their

family of origin after they give birth (Manlove,

Mariner, & Papillo, 2000). Infant care is likely

different from other forms of children’s family

caregiving (i.e., caring for a sick, disabled,

or elderly parent or grandparent) in that one

is caring for a cuddly, beautiful baby. Infant

caretaking can be highly enjoyable, rewarding,

and amusing. It can also be quite labor-intensive

and emotionally stressful, however (Cowan &

Cowan, 2000). Thus, it should be noted that

only infant caretaking was examined in this

study, which may have different ramifications

for adolescents’ adjustment than other forms of

family care.

Conceptual Influences

In conceptualizing caregiving effects, Pearlin

and colleagues outlined a model of the care-

giver stress process that involves appraisals,

mediators, and manifestations of stress (Pearlin,

Mullan, Semple, & Skaff, 1990). Central to the

model is a distinction between primary care-

giving stressors, which encompass the extent

or hours of care provided, and secondary care-

giving stressors, which include the conditions

and experiences surrounding caregiving. Pri-

mary stressors stem directly from the nature and

extent of caregiving demanded and are often

operationalized as hours or tasks involved in

caregiving. Several studies have shown that pri-

mary stressors, particularly the hours of time

committed to caregiving, are associated with

adult caregivers’ poorer mental and physical

health (Pinquart & Sorensen, 2005a; Vitaliano,

Zhang, & Scalan, 2003). Secondary stressors are

not necessarily related to primary stressors but

stem from the caregiver role and take the form

of role strain or interpersonal disagreement or

conflict surrounding care. Such conflict is often

about the way care is provided or that not enough

care is provided (Scharlach, Li, & Dalvi, 2006).

Research on adult caregivers shows that those

who experience high levels of conflict related to

their caregiving report feelings of anger, depres-

sion, and stress, even after considering the hours

of care provided, their age, and gender (Sem-

ple, 1992; Strawbridge & Wallhagen, 1991).

Other studies of adult caregivers emphasize the

importance of disaggregating the magnitude of

care from the experiences surrounding caregiv-

ing, with each having potentially independent

effects on caregivers’ psychological and phys-

ical health (Koerner & Kenyon, 2007; Sands

& Goldberg-Glen, 2000). Very little is known

about the conflict that children and adolescents

experience when providing care or how it affects

their adjustment. For example, the adult caregiv-

ing experience may not be comparable to that of

adolescents because of developmental distinc-

tions. Indeed, conflict may arise from the strug-

gle between the family’s need for cooperation

and interdependence and adolescents’ devel-

oping need for autonomy and independence

(Dellmann-Jenkins, Blankemeyer, & Pinkard,

2001). Too, in some cases, adolescent children’s

less powerful role within the family is exploited

and—because of disadvantaged circumstances

or because others are unable or unwilling—ado-

lescent children are the ones who perform the

large majority of family care (Burton, 2007;

Chase, 1999; Dodson & Dickert, 2004). In such

cases, when care is coerced or provided begrudg-

ingly or resentfully, conflict is likely to arise

that can exacerbate caregiver strain (Scharlach

et al., 2006; Strawbridge & Wallhagen). As a

first step in articulating caregiving effects for

youth, this study examines youths’ experiences

of caregiving conflict and its impact for adjust-

ment independent of the extent of caregiving

provided.

It should be noted that caregiving hours

and caregiving conflict comprise two of many

broad dimensions related to caregiver stress.