Association of Family Member Detention or Deportation With Latino or Latina Adolescents' Later Risks of Suicidal Ideation, Alcohol Use, and Externalizing Problems

US Immigration Policy Stressors and Latinx Youth Mental Health

Importance

The youth mental health crisis is exacerbated for Latinx adolescents, a group whose families are targets of anti-immigrant rhetoric and policy.

Objective

To investigate how immigration-related stressors are associated with disruptions in parent-child relationships and, in turn, the mental health symptoms of Latinx adolescents.

Design, Setting, and Participants

Data for this prospective cohort study of adolescent-mother dyads were derived from surveys completed at 3 time points spanning 4 years (time 1 [T1] in 2018, time 2 [T2] in 2020, and time 3 [T3] in 2022). Mediation analyses estimated paths from immigration-related stressors to parent-child relationship qualities to mental health symptoms from early to late adolescence. Multivariable and multivariate linear models within a structural equation modeling framework regressed mediators and outcome variables on their own T1 values, offering a scientifically rigorous test of mediation. The setting was a school district in suburban Atlanta, Georgia, and included Latinx adolescents (ages 11-16 years) randomly selected from grade and gender strata. Data were analyzed from June 2023 to March 2024.

Exposures

The primary independent variables were T1 mother reports of anti-immigrant worry and behavioral modification and adolescent reports of family member detention or deportation. Mediating variables were the reports of parental support and parent-child conflict of T2 adolescents.

Main Outcomes and Measures

T3 adolescent reports of past 6-month internalizing and externalizing symptoms.

Results

A total of 547 Latinx adolescents (mean [SD] age, 13.3 [1.0] years; 303 female [55.4%]; 244 male [44.6%]) were included in this study. Response rates were 65.2% (547 of 839) among contacted parents and 95.3% (547 of 574) among contacted adolescents with parental permission. Four-year retention rates were 67% (366 of 547 adolescents) and 65% (177 of 271 mothers). Structural model results showed that T1 anti-immigrant worry and behavioral modification was associated with T3 increases in externalizing symptoms indirectly through T1 to T2 increases in parent-child conflict (β = 0.03; SE = 0.02; 95% CI, 0-0.08). For girls, T1 family member deportation or detention was associated with T1 to T3 increases in internalizing and externalizing symptoms indirectly through T1 to T2 declines in parental support (internalizing: β = 0.04; SE = 0.02; 95% CI, 0-0.08; externalizing: β = 0.03; SE = 0.02; 95% CI, 0-0.07). Sensitivity analyses supported structural model findings.

Conclusion and Relevance

Results of this cohort study suggest that legislative bodies, the health care system, and educational institutions should implement safeguards to mitigate potential harm conferred by anti-immigrant environments for parent-child relationships and, in turn, Latinx adolescents' mental health.

Childhood Racism and Cardiometabolic Risk in Latina Mothers Across the First Postpartum Year

OBJECTIVE

Immigrant Latinas, particularly of Mexican descent, initially achieve healthy perinatal outcomes. Although this advantage wears off across generations in the United States (US), the early life psychosocial mechanisms that may initiate a cascade of biological vulnerabilities remain elusive. The current investigation aimed to understand the extent to which childhood experiences of racism may contribute to elevated levels of C-reactive protein (CRP), an early indicator of cardiometabolic risk, during the first postpartum year.

METHODS

Latinas from the Community and Child Health Network ( N = 457) retrospectively reported experiences of childhood racism and childhood country of residence via structured questionnaires. Interviewers collected CRP bloodspots and height and weight measurements for body mass index at 6 months and 1 year postpartum.

RESULTS

Latinas who grew up in the US experienced a steeper increase of CRP levels across the first postpartum year ( β = 0.131, p = .009) and had higher CRP levels 1 year postpartum than Latinas who grew up in Latin America. Based on Bayesian path analyses, Latinas who grew up in the US reported higher levels of childhood racism than Latinas who immigrated after childhood ( β = 0.27; 95% credible interval = 0.16-0.37). In turn, childhood racism mediated the relationship between country of childhood residence and elevated CRP at 6 months and 1 year postpartum, even after adjusting for sociodemographic and behavioral covariates. After adjusting for body mass index, mediational relationships became nonsignificant.

CONCLUSIONS

This study is an important first step toward understanding how childhood racism may contribute to postmigratory health patterns among Latinas, particularly cardiometabolic risk 1 year after childbirth.

Peer Discrimination, Deviant Peer Affiliation, and Latino/a Adolescent Internalizing and Externalizing Symptoms: A Prospective Study

OBJECTIVE

U.S. Latino/a adolescents experience high levels of ethnic discrimination, particularly in new immigrant destinations. Due to the salience of peers during adolescence, this study examined how peer discrimination related directly and indirectly, through deviant peer affiliation, to changes in Latino/a adolescents' internalizing and externalizing symptoms. Culture-specific moderators hypothesized to buffer discrimination impacts on adolescent symptomology included Spanish language enculturation and adolescents' social ties to relatives in the family's country-of-origin.

METHOD

The sample of 547 Latino/a adolescent participants from the Caminos al Bienestar study (55.4% female; age M = 12.8, range = 11-16) was selected at random from middle schools in a large, suburban school district in Atlanta, Georgia. Three time points of survey data spaced roughly 6 months apart were collected during 2018 and 2019.

RESULTS

Results from longitudinal structural equation models revealed that peer discrimination was associated indirectly with increased externalizing symptoms, through increases in affiliation with deviant peers (β = 0.05; SE = 0.02; B = 0.02; 95% CI = 0.01, 0.09). We did not observe direct or indirect effects of peer discrimination on changes in internalizing symptoms, and we found no significant protective effects of either Spanish language enculturation or social ties with the country-of-origin.

CONCLUSIONS

Ethnic discrimination by peers may lead to deviant peer affiliation and, in turn, increased externalizing behaviors. Future research identifying protective factors that buffer discrimination impacts on deviant peer affiliation is needed to inform the development of interventions that can prevent Latino/a adolescents' externalizing symptoms.

Suicide prevention programming across ecological levels: Recommendations from Latinx immigrant origin youth and their parents

INTRODUCTION

Latinx immigrant-origin youth (IOY) have unique risks for suicidal thoughts and behaviors. It has been suggested that these risks should be addressed from an ecological perspective, addressing cultural and family context as well as structural and systemic barriers to prevention. This study sought to explore perspectives of immigrant-origin Latinx adolescents and their caregivers on suicide and its prevention, including the potential impact of stressors specific to immigrant status.

METHOD

Focus groups were conducted in 2018-2019 with Latinx immigrant-origin caregivers (N = 41, 97.5% female) and adolescents (ages = 14-19, N = 56, 50% female). Participants were recruited from community-based organizations in two different cities. A codebook approach to thematic analysis was used to identify themes, which were subsequently mapped onto levels of the Center for Disease Control's Social-Ecological Framework for Violence Prevention.

RESULTS

Participants identified both contributors to suicidal behavior and potential components of prevention programming across ecological levels. Specific recommendations for suicide prevention included engaging in recreation, parenting education and support, enhancing academic supports for adolescents, and enhancing school-family communication. Structural barriers (e.g., caregiver work schedules) to implementing recommendations were described.

DISCUSSION

Our results highlight the potential role of access to school and community-based supports as public health-oriented suicide prevention strategies and suggest a need to address barriers faced by immigrant families in accessing these supports alongside addressing barriers to mental health treatment. Policies impacting immigrant families' financial stability and increasing the availability of recreational and academic opportunities may promote mental health and prevent suicidal thoughts and behavior among IOY. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"I Can Never Feel Safe": Latinx Youth Voices on Psychosocial Impacts of 287(g) in Georgia

Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents' mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a "universal enforcement model," where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health.

Mental Health During Early Adolescence and Later Cardiometabolic Risk: A Prospective Study of US Latinx Youth

PURPOSE

Rising rates of cardiometabolic risk and mental health problems are serious public health concerns for US adolescents, particularly those of Latinx origin. This research examines how Latinx youth's internalizing symptoms during early adolescence are related to sleep problems, overweight/obesity, sedentary behavior, physical activity, healthy diet, and hypertension or diabetes risk during middle and late adolescence.

METHODS

Participants included 547 adolescents listed as "Hispanic" on 2017-18 middle school enrollment lists in a suburban Atlanta, GA school district. Survey data collected at baseline (2018) and four years later (2022) were analyzed using Structural Equation Model. Path estimates from baseline internalizing symptoms to later health behaviors and physical health outcomes adjusted for demographics, the follow-up measure of internalizing symptoms, and correlations among outcome variables. Missing data were handled using Full Information Maximum Likelihood.

RESULTS

At baseline, the 244 (44.6%) male and 303 (55.4%) female participants had a mean (standard deviation) age in years of 13.31 (0.97). Early adolescent internalizing symptoms were associated positively with later sleep problems (ß = 0.36 [95% confidence interval (CI), 0.24-0.48]), overweight/obesity (adjusted odds ratio, 2.57; 95% CI, 1.29-5.15), sedentary behavior (ß = 0.19 [95% CI, 0.09-0.30]), and internalizing symptoms (ß = 0.48 [95% CI, 0.39-0.56]) and inversely with later physical activity (ß = -0.16 [95% CI, -0.27 to -0.05]) and a healthy diet (ß = -0.21 [95% CI, -0.32 to -0.09]).

DISCUSSION

Latinx youth's internalizing symptoms during early adolescence not only track into later adolescence, but they also relate to health behaviors and outcomes underlying cardiometabolic risk during middle and late adolescence.

Profiles of psychosocial stressors and buffers among Latinx immigrant youth: Associations with suicidal ideation

This study aimed to examine the associations of latent profile group membership based on post-migration psychosocial stressors (proximal immigrant minority stress) and buffers (family, peer, and school support, and ethnic identity importance), and distal stressors (pre- to post-migration victimization and forced immigration-related family separation) with suicidal ideation among immigrant youth from the Northern Triangle (NT). Surveys were administered in a public high school-based Latinx immigrant youth support program between Spring 2019 and Spring 2022 (N = 172). A three latent profile model was previously identified, characterized by moderate stress/low buffer (weak resources), moderate stress/moderate buffer (average resources), and low stress/high buffer (strong resources) levels of psychosocial stressors and buffers. Associations of profile membership and the previously mentioned distal stressors with suicidal ideation were examined using multivariable logistic regression. Findings revealed that youth in the strong resources group experienced significant protection from suicidal ideation compared to youth in both the average and weak resources groups. Distal stressors were not significantly associated with suicidal ideation in multivariable analysis. Immigrant youth from the NT may require substantial buffering resources (i.e., ethnic identity importance, and school, family, and peer support) and minimization of proximal immigrant minority stress during post-migration to experience protection from suicidal ideation.

The role of thwarted belongingness and perceived burdensomeness in passive suicide ideation among Latinx and Black youth

INTRODUCTION

The interpersonal theory of suicide (IPTS) is used to evaluate suicide risk. Yet, it has not been sufficiently tested with ethnoracially minoritized youth. This study aimed to test whether thwarted belongingness (TB) and perceived burdensomeness (PB) were associated with passive suicide ideation (SI) among Latinx and Black youth.

METHODS

Data were obtained from a cross-sectional study. Some youth participants were recruited from an ongoing NIMH study of depressed Black youth in schools (N = 20). The rest were participants in a supplemental study of non-depressed Latinx and Black youth in community agencies (N = 61). Multivariate logistic regression analyses were conducted to examine the relationships between passive SI and the IPTS constructs.

RESULTS

Most participants identified as male (63.5%) and Latinx (59.5%), mean age 15.23 (SD = 1.4). Only TB remained significant when adjusting for age and gender, even after adding a measure of depression symptoms as a covariate. Notably, the interaction term (TBXPB) was not significantly associated with increased odds of passive SI in this sample.

CONCLUSION

These findings confirm the importance of examining the IPTS constructs and their relationship to passive SI in diverse populations. The relationship between TB and SI in Latinx and Black youth suggests it may be an important target for suicide prevention.

Intersectionality and adolescent medicine: an overview

PURPOSE OF REVIEW

This review defines intersectionality, discusses recent studies that use an intersectional framework in adolescent health research, and outlines ways where clinicians can use intersectionality to address health disparities in youth of color through clinical practice, research, and advocacy.

RECENT FINDINGS

Research using an intersectional framework can identify populations at risk for certain disorders or behaviors. Recent studies in adolescent health research using an intersectional lens identified lesbian girls of color as an at-risk population for e-cigarette use, demonstrated lower skin color satisfaction among Black girls of all ages predicted greater binge-eating disorder symptoms, and showed that two-thirds of Latine (gender-neutral term that refers to people with Latin American roots) youth who recently immigrated to the United States experienced at least one traumatic event during their migration journey, putting them at risk for PTSD and other mental health disorders.

SUMMARY

Intersectionality refers to how multiple social identities intersect to produce a specific experience that reflects overlapping systems of oppression. Diverse youth contain multiple identities that intersect to produce unique experiences and health inequities. Using an intersectional framework acknowledges that youth of color are not homogenous. Intersectionality becomes an important tool to care for marginalized youth and advance health equity.

Familism values and psychological adjustment of Latinx adolescents in an emerging immigrant community: A five wave longitudinal study

This study examined the relations between normative developmental changes of familism values and later internalizing and externalizing behaviors in Latinx adolescents from an emerging immigrant community. The sample included 547 Latinx adolescents (55.4% female; baseline Mage = 12.80; SD = 1.03) residing in the Southeastern United States. Results from latent growth models indicated that higher initial levels of familism values (intercept) and slower declines (slope) in familism values across adolescence predicted lower internalizing and externalizing behaviors at a later time. These associations generalized across adolescent gender (boys and girls) and ethnic background (Mexican-origin vs. other Latinx-origin). This work highlights the impact of variation in normative developmental changes in familism values on adjustment among Latinx adolescents in an emerging immigrant community context. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychosocial Predictors of Suicidal Thoughts and Behaviors in Mexican-Origin Youths: An 8-Year Prospective Cohort Study

Suicide is the second leading cause of death for youths in the United States. More Latino adolescents report suicidal thoughts and/or behaviors (STBs) than youths of most other ethnic communities. Yet few studies have examined multiple psychosocial predictors of STBs in Latino youths using multiyear longitudinal designs. In this study, we evaluated the progression of STBs in 674 Mexican-origin youths (50% female) from fifth grade (10 years old) to 12th grade (17 years old) and identified psychosocial predictors of changes in STBs across this period. Latent growth curve models revealed that being female and later-generation status were associated with increasing prevalence in STBs across adolescence. Family conflict and peer conflict predicted increased STBs, whereas greater familism predicted less STBs. Thus, interpersonal relationships and cultural values contribute to the development of STBs in Mexican-origin youths and may be key levers for decreasing suicidality in this understudied but rapidly growing portion of the U.S. adolescent population.

Increased adolescent game usage and health-related risk behaviors during the COVID-19 pandemic

This study examines adolescent game usage and corresponding health-related risk behaviors during a period of limited social interaction and activity due to the COVID-19 pandemic. Participants included 225 middle- and 225 high-school students in Seoul who completed a survey online from October 1 to 30, 2021. The study measured participants' game usage level and the health-related risk behavior index. Findings showed that participants who engaged in excessive gaming showed higher levels of health-related risk behaviors. A multivariate analysis of variance was conducted to compare the health-related risk behaviors of students in the general, potential, and high-risk groups on excessive gaming. Results indicated that female students in the high-risk group showed higher stress levels and fatigue (f = 5.549, p < .01, Cohen's d = 0.016) than the males of the same group. However, male students showed higher physical inactivity levels (f = 3.195, p > .05, Cohen's d = 0.009) than females. The post hoc test indicated clear sex distinctions among the general, potential, and high-risk groups on excessive gaming (p < .001). Among the high-risk game usage group, female students displayed a higher level of risk behaviors than males. Adolescent gaming addiction should be considered an emotional and behavioral disorder for which parental guidance and support are needed, and counseling experts and professionals must come together to provide a cure and reform program.

Fear of Deportation and Associations with Mental Health Among Michigan Residents of Middle Eastern & North African Descent

Anti-immigrant rhetoric and immigration policy enforcement in the United States over the last 2 decades has increased attention to fear of deportation as a determinant of poor health. We describe its association with mental health outcomes among Middle East and North African (MENA) residents of Michigan. Using a convenience sample of MENA residents in Michigan (n = 397), we conducted bivariate and multiple variable regression to describe the prevalence of deportation worry and examine the relationship between deportation worry and depressive symptoms (PHQ-4 scores). We found that 33% of our sample worried a loved one will be deported. Deportation worry was associated with worse mental health (p < 0.01). Immigration policies are health policies and deportation worry impacts mental and behavioral health.

Immigration Enforcement and Hispanic Youth Substance Use: Is Depression a Mediator?

Hispanic adolescents report earlier onset and higher substance use rates than their non-Hispanic White and Black peers. This study examines the associations between the immigration-related arrest of a family member and substance use among Hispanic early adolescents and explores the mediating role of depressive symptoms as the mechanism explaining the association. We apply a mediated multiple linear regression analysis on 661 Hispanic youth attending 7th grade in an urban school district in a south-central, new arrival state. We found that Hispanic early adolescents who experienced the immigration-related arrest of a family member reported significantly higher substance use than Hispanic youth who did not experience the arrest of a family member due to immigration enforcement. Moreover, we found this relationship to be fully mediated by depressive symptoms. Findings suggest that even though the majority of Hispanic youth in the U.S. are citizens, experiencing the immigration-related arrest of a family member is not uncommon and has critical implications for poor mental health and maladaptive coping behaviors.

Addressing health inequities for children in immigrant families: Psychologists as leaders and links across systems

What can psychologists do to address social determinants of health and promote health equity among America's approximately 20 million children in immigrant families (CIF)? This article identifies gaps in current research and argues for a stronger role for psychologists. Psychologists can advocate for and enact changes in institutional systems that contribute to inequities in social determinants of health and promote resources and services necessary for CIF to flourish. We consider systemic exclusionary and discriminatory barriers faced by CIF, including a heightened anti-immigrant political climate, continued threat of immigration enforcement, restricted access to the social safety net, and the disproportionate health, economic, and educational burden of the COVID-19 pandemic. We highlight the potential role of psychologists in (a) leading prevention that addresses stressors such as poverty and trauma; (b) changing systems to mitigate risk factors for CIF; (c) expanding workforce development across multiple disciplines to better serve their needs; (d) identifying mechanisms, such as racial profiling, that contribute to health inequity, and viewing them as public health harms; and (e) guiding advocacy for resources at local, state, and federal levels, including by linking discriminatory policies or practices with health inequity. A key recommendation to increase psychologists' impact is for academic and professional institutions to strengthen relationships with policymakers to effectively convey these findings in spaces where decisions about policies and practices are made. We conclude that psychologists are well positioned to promote systemic change across multiple societal levels and disciplines to improve the well-being of CIF and offer them a better future. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Mediating Role of Home-School Dissonance in Linking Maternal Discrimination to Latin American-Origin Adolescent Academic Performance

Latin American-origin parents play an important role in supporting the formal education of their youth, but cultural, linguistic, and systemic barriers make parent involvement difficult. The aim of the present study was to examine how Latina mothers' experiences with discrimination were associated with short-term changes in their adolescent children's academic performance, directly and indirectly through mothers' appraisal of home-school dissonance. Data were drawn from an ongoing longitudinal study of 547 mother-youth dyads in suburban Atlanta. Results showed a significant indirect relationship between mothers' experiences of discrimination and declines in adolescents' grade point average by way of increased home-school dissonance. Thus, Latina mothers' discriminatory experiences may have spillover effects on adolescent academic achievement through increasing proximal barriers to parent involvement.

Disparities in Pediatric Mental and Behavioral Health Conditions

Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years old and have been increasing disproportionately among adolescent Black girls 12 to 17 years old. Children identifying as a sexual minority have >3 times increased odds of attempting suicide compared to heterosexual peers. Adverse experiences of children living as part of a minority group, including racism and discrimination, have immediate and lasting effects on mental health. Poverty and an uneven geographic distribution of resources also contribute to inequities in access and disparities in outcomes for mental and behavioral health conditions. Strategies to address inequities in mental and behavioral health among United States children include investing in a diverse workforce of mental health professionals, improving access to school-based services, ensuring equitable access to telehealth, and conducting quality improvement with rigorous attention to equity.

School racial-ethnic discrimination, rule-breaking behaviors and the mediating role of trauma among Latinx adolescents: Considerations for school mental health practice

Much of the literature linking adversity to trauma fails to account for racialized experiences, including racial-ethnic discrimination, which is a highly prevalent form of adversity for youth of color in the U.S. Adversity and trauma often result in students experiencing elevated rule-breaking behaviors, exacerbating existing racial-ethnic disparities in disproportionate school discipline. Drawing from race-based trauma theory, the present study explored trauma as a mediator of the longitudinal association between racial-ethnic discrimination from teachers, other adults, and students in schools and rule-breaking behaviors among Latinx youth. Data were from a longitudinal study of 547 Latinx students in a southeastern U.S. state. Across gender and nativity groups, school racial-ethnic discrimination and trauma positively predicted later rule-breaking behaviors. Additionally, for girls only, increased levels of trauma partially explained the association between school racial-ethnic discrimination and rule-breaking behaviors. The study highlights the importance of addressing school racial-ethnic discrimination and trauma in equitable school metal health systems. Indeed, efforts aimed at reducing disproportionate school discipline among Latinx students should focus on reducing their exposure to school racial-ethnic discrimination and increasing access to trauma-informed and restorative justice approaches.

Immigration policies as political determinants of alcohol and drug misuse among US-born Latinos

BACKGROUND

The role of immigration policies as political determinants of health among US-born Latinos is significantly understudied. Immigration policies can produce immigration-related stressors that have 'spill over' effects on the health behaviors of US-born Latinos. However, less is known about how immigration-related stressors relate to substance misuse among US-born Latinos.

METHODS

1,784 US-born Latinos were recruited via web-panels in September 2021 to complete an online questionnaire. Inclusion criteria included: (1) self-identifying as Latino; (2) born in the US; and (3) being 18 years of age or older. Participants were asked 14-items related to immigration-related stressors and past-year substance use behaviors. Dependent variables included past-year: heavy drinking, high intensity drinking, illicit drug use, prescription drug misuse, cannabis use, cocaine use, methamphetamine use, prescription sedative misuse, and prescription opioid misuse. Two separate multivariable logistic regression models were conducted for each outcome to investigate associations between (1) specific immigration-related stressors and substance misuse; and (2) experiencing greater (vs. fewer) number of immigration-related stressors and substance misuse.

RESULTS

On average, US-born Latinos reported experiencing 3 immigration-related stressors. In multivariable analyses, being fearful or worried about being detained for immigration reasons was associated with increased odds of engaging in heavy drinking, high intensity drinking, and illicit drug use. Having ever feared or worried about being potentially deported for immigration reasons and having ever witnessed or experienced an immigration raid was associated with high intensity drinking. Parental detentions and deportations in childhood were independently associated with high intensity drinking, illicit drug use, and prescription drug misuse. Notably, greater number of immigration-related stressor experiences increased the odds of substance misuse.

CONCLUSION

Punitive immigration and enforcement policies give rise to multiple stressors that may render US-born Latinos vulnerable to misusing substances as a way of coping. Policies and public health interventions aimed at preventing and treating substance misuse should consider how immigration policies impact the behaviors of US-born Latinos.

A longitudinal test of acculturative family distancing theory explaining latino/a/x adolescents' adjustment

According to acculturative family distancing theory, adolescents' perceptions of cultural incongruencies with parents can diminish the quality of parent-adolescent relationships and, as a result, harm adolescent adjustment. Using four time points of data for a sample of 547 diverse Latino/a/x adolescents, this study examined how parent-adolescent relationship quality and acculturative family distancing were associated with changes in adolescent school performance and internalizing symptoms. At baseline, the school-based sample ranged from 11- to 14-years-old (M = 12.78) and included slightly more females (55%) than males (45%). Cross-lagged structural equation model results indicated that adolescent reports of greater acculturative family distancing were associated with adolescent perceived increases in parent-adolescent conflict and decreases in parental support. Conflict mediated associations between acculturative family distancing and decreased school performance. Associations between parent-child relationship qualities and Latino/a/x adolescent adjustment were bidirectional.

Systems of Oppression: The Impact of Discrimination on Latinx Immigrant Adolescents' Well-Being and Development

With over 400 harmful immigration policy changes in the past 4 years, Latinx adolescents and families nationwide are developing within a context of extreme anti-immigrant sentiment (Dismantling and reconstructing the U.S. immigration system: A catalog of changes under the Trump presidency, Migration Policy Institute, 2020). This paper introduces the Multitiered Model of Oppression and Discrimination (MMOD), a conceptual model for understanding the impacts of multiple levels of discrimination on the well-being and development of Latinx immigrant adolescents. Interpersonal discrimination (Hispanic Journal of Behavioral Sciences, 2010, 32, 259), community-held stereotypes (Social Psychology of Education, 2001, 5, 201), institutional policies (Children and Youth Services Review, 2018, 87, 192), and structural practices (Journal of Criminal Justice, 2020, 66, 1) can negatively impact well-being and development among these adolescents. Culturally sustaining interventions, civic engagement and mobilization, and policies targeting inequitable policies and practices will provide healing and an avenue for liberation.

COVID-19 Stressors and Latinx Adolescents' Mental Health Symptomology and School Performance: A Prospective Study

This study addressed the need for research examining impacts of the Coronavirus-19 (COVID) pandemic on Latinx adolescents’ adjustment. Survey data for a probability sample of 547 Latinx adolescents (M_age = 13.71, SD = 0.86; 55.2% female) were collected from 2018 to 2021, including two times both prior to, and during, COVID. Independent variables assessed COVID-related household hospitalization, job/income loss, and adolescents’ increased childcare responsibility. Structural Equation Model results indicated that COVID-related increases in adolescent childcare responsibility were associated with increased internalizing and externalizing symptoms and declines in school performance. COVID hospitalization and job/income loss were associated indirectly, through childcare responsibilities, to worse adolescent outcomes. Family adversities may harm adolescents’ adjustment by burdening adolescents with responsibilities such caring for children.

Suicide and Suicidal Behaviors Among Minoritized Youth

Suicide rates continue to increase among children and adolescents in the United States, with suicide remaining the second leading cause of death for youth aged 10 to 24 years of age. Most studies of suicide among children and adolescents have not focused on youth of color because of research suggesting that suicide was a health threat for white youth. Research showing shifting trends in suicide for minoritized youth of color has increased national focus, revealing disparities in recognition and treatment of suicidal behaviors for racially and culturally diverse youth.

Impact of Anti-Immigrant Rhetoric on Latinx Families' Perceptions of Child Safety and Health Care Access

BACKGROUND

Political rhetoric from the former U.S. president influences Latinx adults' feelings of safety and their decisions to seek care in the emergency department (ED).

OBJECTIVE

Our aim was to examine the impact of political rhetoric on feelings of safety and health care access in the pediatric population.

METHODS

This was a cross-sectional study of undocumented Latinx families (ULF), Latinx U.S. citizen families (LCF), and non-Latinx U.S. citizen families (NLF) conducted from November 2018 through February 2020 by means of interviewing a convenience sample of parents and guardians who brought their child to a pediatric clinic and two EDs in California.

RESULTS

Of 705 parents approached, 449 (63.7%) agreed to participate: 138 ULF, 150 LCF, and 158 NLF. Most ULF (95%), LCF (88%), and NLF (78%) parents and guardians had heard anti-immigrant statements from the former U.S. president and most (94% ULF, 90% LCF, 86% NLF) believed these measures against immigrants were being enacted or will be enacted. More ULF (75%, 95% confidence interval [CI] 67-81%) reported that these statements made them concerned about their child's safety in the United States compared with 36% (95% CI 28-45%) and 34% (95% CI 26-43%) of LCF and NLF, respectively. More ULF 17% (95% CI 11-24%) said that these statements made them afraid to bring their child for medical care, compared with 5% (95% CI 2-10%) and 3% (95% CI 1-7%) of LCF and NLF, respectively.

CONCLUSIONS

Most parents heard statements against undocumented immigrants by the former U.S. president and most believed measures were being enacted. This rhetoric had a substantial negative impact on ULF parents in terms of safety concerns for their child and fear of accessing health care.

Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns

OBJECTIVE

Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists.

METHOD

We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health.

RESULTS

First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment.

CONCLUSION

Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.

An ecological expansion of the adverse childhood experiences (ACEs) framework to include threat and deprivation associated with U.S. immigration policies and enforcement practices: An examination of the Latinx immigrant experience

The Adverse Childhood Experiences (ACEs) framework has contributed to advances in developmental science by examining the interdependent and cumulative nature of adverse childhood environmental exposures on life trajectories. Missing from the ACEs framework, however, is the role of pervasive and systematic oppression that afflicts certain racialized groups and that leads to persistent threat and deprivation. In the case of children from immigrant parents, the consequence of a limited ACEs framework is that clinicians and researchers fail to address the psychological violence inflicted on children from increasingly restrictive immigration policies, ramped up immigration enforcement, and national anti-immigration rhetoric. Drawing on the literature with Latinx children, the objective of this conceptual article is to integrate the ecological model with the dimensional model of childhood adversity and psychopathology to highlight how direct experience of detention and deportation, threat of detention and deportation, and exposure to systemic marginalization and deprivation are adverse experiences for many Latinx children in immigrant families. This article highlights that to reduce bias and improve developmental science and practice with immigrants and with U.S.-born children of immigrants, there must be an inclusion of immigration-related threat and deprivation into the ACEs framework. We conclude with a practical and ethical discussion of screening and assessing ACEs in clinical and research settings, using an expanded ecological framework that includes immigration-related threat and deprivation.

Recent immigration actions and news and the adjustment of U.S. Latino/a adolescents

OBJECTIVES

This research describes how family immigrant statuses are related to Latino/a adolescents' responses to recent immigration actions and news and, in turn, adolescent adjustment.

METHOD

Study 1 included a school-based sample of 11- to 15-year-olds in suburban Atlanta, Georgia (N = 547); Study 2 included a convenience sample of 15- to 18-year-olds in the Washington, DC area (N = 340). Family immigrant status was defined by adolescents' immigrant generation status in Study 1 and by parent residency status in Study 2. In both studies, a 14-item measure assessed responses to recent immigration actions and news, including psychological worries and behavioral withdrawal. Dependent variables included internalizing and externalizing symptoms, suicidal ideation, e-cigarette use, and alcohol use (Study 1), and alcohol use and depressive symptoms (Study 2).

RESULTS

Psychological worry and behavioral withdrawal responses to immigration actions and news were significantly greater among adolescents with foreign-born, compared to U.S.-born, parents (Study 1), and among adolescents with undocumented, Temporary Protected Status (TPS), or permanent resident parents, as compared to citizen parents (Study 2). Results from tests of indirect effects indicated that these worries and behavioral withdrawal responses were, in turn, associated with higher levels of adolescent internalizing and externalizing symptoms, a higher odds of substance use and suicidal ideation (Study 1), and higher levels of adolescent depressive symptoms (Study 2).

CONCLUSIONS

As 1-quarter of the U.S. child population is Latino/a, there is a need to address immigration threats jeopardizing the adjustment of Latino/a teenagers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Family Strengths and Latinx Youth Externalizing Behavior: Modifying Impacts of an Adverse Immigration Environment

In recent years, the federal administration has ramped up efforts to curb and enforce immigration laws, in essence redefining how immigration, particularly in the Latinx population, is viewed and dealt with in the United States. The aim of the present study was to examine Latinx family strengths in relation to youth externalizing behavior, considering the modifying impacts of the current anti-immigration environment. Data were drawn from a study of 547 mother-adolescent dyads. Adolescents were 12.80 years old (SD = 1.03) on average and 55% female; 88% were U.S. born. Adolescents completed measures of family strengths, including parental behavioral control, parental support, and respeto. They also reported on their own externalizing behavior. Mothers completed a measure of their affective and behavioral responses to immigration actions and news. Results showed that in families of mothers who reported adverse responses to the immigration context, parental behavioral control, parental support (boys only), and respeto were more strongly related to youth behavior. Results align with the family compensatory effects model, in which strengths at the family level help to offset adversities outside the home. Discussion focuses on ways to support families in establishing and maintaining high levels of protective processes and on the need to challenge anti-immigration rhetoric, practices, and policies that undermine healthy youth development in the Latinx population.

The adverse health effects of punitive immigrant policies in the United States: A systematic review

BACKGROUND

Immigrants in the United States (US) today are facing a dynamic policy landscape. The Trump administration has threatened or curtailed access to basic services for 10.5 million undocumented immigrants currently in the US. We sought to examine the historical effects that punitive laws have had on health outcomes in US immigrant communities.

METHODS

In this systematic review, we searched the following databases from inception-May 2020 for original research articles with no language restrictions: Ovid MEDLINE, Ovid EMBASE, Cochrane Library (Wiley), Web of Science Core Collection (Clarivate), CINAHL (EBSCO), and Social Work Abstracts (Ovid). This study is registered with PROSPERO, CRD42019138817. Articles with cohort sizes >10 that directly evaluated the health-related effects of a punitive immigrant law or policy within the US were included.

FINDINGS

6,357 studies were screened for eligibility. Of these, 32 studies were selected for inclusion and qualitatively synthesized based upon four themes that appeared throughout our analysis: (1) impact on healthcare utilization, (2) impact on women's and children's health, (3) impact on mental health services, and (4) impact on public health. The impact of each law, policy, mandate, and directive since 1990 is briefly discussed, as are the limitations and risk of bias of each study.

INTERPRETATION

Many punitive immigrant policies have decreased immigrant access to and utilization of basic healthcare services, while instilling fear, confusion, and anxiety in these communities. The federal government should preserve and expand access for undocumented individuals without threat of deportation to improve health outcomes for US citizens and noncitizens.

A Community-Based Organization Model to Promote Latinx Immigrant Mental Health Through Advocacy Skills and Universal Parenting Supports

The unique mental health context of children in Latinx immigrant families calls for innovative community-based intervention strategies. We use an ecological public health approach to highlight the importance of community-based organization (CBO) settings, the critical role of community-based paraprofessionals (i.e., non-clinicians, near-peers) and capacity-building, and the expansion of mental health promotion strategies to include realistic, day-to-day supports for Latinx immigrant parents and families. This realigns mental health with the goals and mission of trusted spaces, like CBOs, that can offer more equitable and non-stigmatized access for Latinx immigrant families. We draw upon two strength-based and empowerment-focused interventions that utilize community-based workforces to promote positive parenting skills (Partners Achieving Student Success-PASS; Mehta et al., 2019) and self-advocacy skills (Community Advocacy Project-CAP; Sullivan & Bybee, 1999) to provide the conceptual framework for Family Mental Health Advocacy (FMHA). FMHA aligns mental health promotion with the advocacy mission of CBOs, engages CBO staff with feasible mental health "messages," and empowers immigrant parents as critical change agents in the lives of their children. We acknowledge the challenges associated with implementing mental health promotion strategies and providing workforce support, as well as the importance of local and national policy influences.

Disparities in Mental and Behavioral Health Treatment for Children and Youth in Immigrant Families

BACKGROUND AND OBJECTIVE

Children and youth in immigrant families (CIF)-children and youth with at least 1 foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental and behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, we assessed access to MBH treatment.

METHODS

We used the National Survey of Children's Health-2016, a nationally representative survey of predominantly English- or Spanish-speaking US parents. The sample included 2- to 17-year-olds whose parent reported at least 1 MBH problem. The primary outcome was prior-year receipt of MBH treatment (counseling, medication, or both).

RESULTS

Of 50,212 survey respondents, 7164 reported a current MBH problem (809 CIF and 6355 non-CIF). The majority of CIF were Hispanic/Latinx (56% CIF vs 13% non-CIF, P < .001). CIF were less likely than non-CIF to have an Attention Deficit Hyperactivity Disorder (ADHD) diagnosis (35% vs 59%, P < .001) and less likely to have received MBH medication and/or counseling (61% vs 71%, P = .02). This difference was pronounced for receiving medication (32% vs 50%, P < .001). When controlling for multiple covariates, differences in any MBH treatment were no longer statistically significant (adjusted odds ratios 0.76, 95% confidence interval 0.52-1.11), while the odds of receipt of medication remained significantly lower for CIF (adjusted odds ratios 0.61, 95% confidence interval 0.42-0.88).

CONCLUSIONS

Among children and youth with at least 1 parent-reported MBH problem, CIF, compared with non-CIF, were less likely to receive MBH treatment, specifically medication. This may be explained, in part, by differences in the proportion of CIF and non-CIF diagnosed with ADHD.