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Pnishi I, Shala M, Morina N, Maercker A, Heim E. Cultural concepts of distress among Albanian young adults living in Switzerland - a qualitative study. Front Psychol 2024; 15:1321452. [PMID: 38770258 PMCID: PMC11104449 DOI: 10.3389/fpsyg.2024.1321452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Objectives Existing research recognizes the critical role that social, sociodemographic, and acculturative processes play in increasing vulnerability for experiencing psychological distress among second-generation migrants. However, to date, far too little attention has been given to the study of psychological distress in this social group. The main objective of this study is to examine cultural identities, as well as expressions and causes of psychological distress among second-generation Albanian-speaking migrants in Switzerland. Methods Semi-structured qualitative interviews were conducted with 13 Albanian-speaking participants between 19 and 35 years of age using the interview of the Barts Explanatory Model Inventory. Data were analyzed by qualitative content analysis using MAXQDA-2018 software. Findings Study participants showed bicultural identities, which caused value conflicts and a feeling of being "caught" between Swiss and Albanian culture. Some participants experienced the fear of disappointing their parents. Others find it difficult to deal with conflicting norms and values. Parentification was another important cause within their cultural concept of distress. At the same time, (implicit) social support, i.e., spending time with the family and the community, was an important coping mechanism. Conclusion Second-generation immigrants are exposed to specific risk factors for psychological distress. A better understanding of these risk factors and their coping mechanisms is essential for providing them with meaningful support services, both in prevention and psychotherapy.
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Affiliation(s)
- Imer Pnishi
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zürich, Switzerland
| | - Mirëlinda Shala
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zürich, Switzerland
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zürich, Switzerland
| | - Eva Heim
- Institute of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zürich, Switzerland
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Azman Ö, Mauz E, Reitzle M, Geene R, Hölling H, Rattay P. Associations between Parenting Style and Mental Health in Children and Adolescents Aged 11-17 Years: Results of the KiGGS Cohort Study (Second Follow-Up). CHILDREN (BASEL, SWITZERLAND) 2021; 8:672. [PMID: 34438563 PMCID: PMC8394813 DOI: 10.3390/children8080672] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Few studies from Germany have investigated the associations between parenting style and children's and adolescents' health. Little attention has been directed to whether these associations vary with familial socioeconomic or migration status. The aim of this analysis was to investigate the association between parenting style and the mental health of children and adolescents aged 11-17 years using data from the KiGGS cohort study (second follow-up). We calculated mean Strengths and Difficulties Questionnaire (SDQ) total difficulties scores stratified by parenting style (authoritative, permissive, demanding-controlling, emotional distancing). Linear regression analyses adjusted for age, gender, socioeconomic status, migration status, and family status were performed. We also analyzed moderating effects of socioeconomic and migrations status on associations between parenting style and SDQ scores. There were only small differences between the permissive and the authoritative parenting styles. Significantly higher mean scores were observed for the demanding-controlling and emotional distancing styles for both the mother and father. These associations persisted after full adjustment and did not vary by socioeconomic or migration status. Parenting behavior is an important predictor of children's and adolescents' mental health. The promotion of good relationships within families and improving parenting skills offer promising approaches for health promotion in young people.
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Affiliation(s)
- Özge Azman
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Elvira Mauz
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Matthias Reitzle
- Department of Developmental Psychology, Friedrich Schiller University of Jena, Am Steiger 3/1, 07743 Jena, Germany;
| | - Raimund Geene
- Department of Health & Education, Berlin School of Public Health, Alice Salomon University of Applied Sciences, Alice-Salomon-Platz 5, 12627 Berlin, Germany;
| | - Heike Hölling
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
| | - Petra Rattay
- Department Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany; (E.M.); (H.H.); (P.R.)
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Jiang H, Shek DTL, Law MYM. Differences between Chinese Adolescent Immigrants and Adolescent Non-Immigrants in Hong Kong: Perceived Psychosocial Attributes, School Environment and Characteristics of Hong Kong Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073739. [PMID: 33918464 PMCID: PMC8038285 DOI: 10.3390/ijerph18073739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 01/07/2023]
Abstract
Although the impact of immigration on adolescent developmental outcomes has received extensive scholarly attention, the impact of internal migration, particularly in the Chinese context, on adolescents’ psychosocial development has not been scientifically investigated. This study examined whether mainland Chinese adolescent immigrants (N = 590) and adolescent non-immigrants (n = 1798) differed on: (a) psychosocial attributes indexed by character traits, well-being, social behavior, and views on child development, (b) perceived school environment, and (c) perceptions of characteristics of Hong Kong adolescents. Consistent with the healthy migration hypothesis, Hong Kong adolescents and mainland Chinese adolescent immigrants did not differ on most of the outcomes; Chinese adolescent immigrants showed higher perceived moral character, empathy, and social trust than did Hong Kong adolescent non-immigrants. Chinese adolescent immigrants also showed more favorable perceptions of the school environment and moral character, social trust and social responsibility of adolescents in Hong Kong. This pioneer Chinese study provides support for the healthy immigration hypothesis (immigration paradox hypothesis) but not the immigration morbidity hypothesis within the specific sociocultural context of Hong Kong in China.
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Affiliation(s)
- Hechao Jiang
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu 611130, China;
| | - Daniel T. L. Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Correspondence:
| | - Moon Y. M. Law
- Department of Applied Social Sciences, HKCT Institute of Higher Education, Hong Kong SAR 999077, China;
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Bretones FD, Jain A, Leka S, García-López PA. Psychosocial Working Conditions and Well-Being of Migrant Workers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2547. [PMID: 32276385 PMCID: PMC7178116 DOI: 10.3390/ijerph17072547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 11/23/2022]
Abstract
This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = 8508) to identify the main latent variables that influenced well-being. Using structural equation modeling and multivariate analysis, we found different patterns and perceptions of well-being and working conditions in these two groups. We discuss the reasons for these differences and suggest directions for further research in this area.
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Affiliation(s)
- Francisco Díaz Bretones
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
| | - Aditya Jain
- Nottingham University Business School, University of Nottingham, Nottingham NG8 1BB, UK;
| | - Stavroula Leka
- Cork University Business School, University College Cork, T12 K8AF Cork, Ireland;
- Centre for Organizational Health and Development, School of Medicine, University of Nottingham, Nottingham NG8 1BB, UK
| | - Pedro A. García-López
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
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Duinhof EL, Smid SC, Vollebergh WAM, Stevens GWJM. Immigration background and adolescent mental health problems: the role of family affluence, adolescent educational level and gender. Soc Psychiatry Psychiatr Epidemiol 2020; 55:435-445. [PMID: 31932903 DOI: 10.1007/s00127-019-01821-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/28/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE European studies demonstrated that immigrant adolescents are at a higher risk for mental health problems than native adolescents, but little is known about the role of socioeconomic status (SES) and gender in this association. This study examined to what extent differences in the mental health problems of non-western immigrant and native Dutch adolescents were explained by adolescents' family affluence and educational level and differed with the adolescents' family affluence, educational level, and gender. METHODS Adolescents in a Dutch nationally representative sample of 11-16-year old native Dutch (n = 5283) and non-western immigrants (n = 1054) reported on their family affluence, own educational level, conduct problems, emotional symptoms, peer relationship problems, and hyperactivity-inattention problems. RESULTS Non-western immigrant adolescents were at a higher risk for conduct problems and peer relationship problems than native Dutch adolescents, but family affluence and educational level explained only a very small proportion of these differences. With two exceptions, differences in the mental health problems of non-western immigrants and natives were highly comparable for different family affluence levels, educational levels, and for boys and girls. Only for natives, a higher family SES was related to less conduct problems. Furthermore, only for non-western immigrants a high family SES related to more hyperactivity-inattention problems. CONCLUSIONS Our findings illustrate that the association between immigration background and adolescent mental health problems is largely independent of SES and gender. Future studies should include other factors to facilitate our understanding of the association between immigration background and adolescent mental health problems.
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Affiliation(s)
- E L Duinhof
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands.
| | - S C Smid
- Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands
| | - W A M Vollebergh
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands
| | - G W J M Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80.140, 3508 TC, Utrecht, The Netherlands
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Chi X, Huang L, Wang J, Zhang P. The Prevalence and Socio-Demographic Correlates of Depressive Symptoms in Early Adolescents in China: Differences in Only Child and Non-Only Child Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E438. [PMID: 31936468 PMCID: PMC7014354 DOI: 10.3390/ijerph17020438] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/30/2019] [Accepted: 01/03/2020] [Indexed: 01/16/2023]
Abstract
This study explores the prevalence and socio-demographic correlates of depressive symptoms in early adolescents in China, as well as the differences between an only child and non-only child group. A total of 2059 seventh-grade Chinese students were invited to complete a questionnaire, which included questions concerning socio-demographic factors, family function, and the Center for Epidemiological Studies Depression Scale (CES-D). The results revealed the following things. (1) thirty-four point seven percent of the participating Chinese early adolescents display symptoms of depression according to Radloff's criteria. Differences are significant across the four dimensions (i.e., positive affect, negative affect, somatic symptoms and retarded activity, and interpersonal difficulties), as well as across total scores between only children and children with sibling(s). (2) Academic achievement, having sibling(s) or not, migration, and family function can significantly predict depressive symptoms. (3) Two significant interactions were found, which were between sibling(s) and gender as well as sibling(s) and family function. Girls from the non-only child group and adolescents from the only child group with poor family function were more likely to have depressive symptoms. These findings suggest that a greater focus should be placed on girls from non-only child families, academic under-performers, migrants, and adolescents from poor family environments, and especially only children, to prevent or reduce the propensity for depressive symptoms.
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Affiliation(s)
- Xinli Chi
- College of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen 518060, China
| | - Liuyue Huang
- College of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen 518060, China
| | - Jian Wang
- College of Politics and Law, Anhui University of Architecture, Hefei 230000, China
| | - Peichao Zhang
- Research Center of Modern Psychology, Wuhan University, Wuhan 430071, China
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Jeong S, Kang C, Cho H, Kang HJ, Jang S. Socioeconomic determinants affecting the access and utilization of depression care services in immigrants: A population-based study. PLoS One 2019; 14:e0213020. [PMID: 30865684 PMCID: PMC6415893 DOI: 10.1371/journal.pone.0213020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 02/13/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It is imperative to address the health problems faced by immigrants in their destination countries in light of the current magnitude of migration processes worldwide. We aimed to evaluate the socioeconomic determinants of healthcare utilization in immigrants with depression. METHOD A population-based cohort comprising all immigrants who were eligible for National Health Insurance coverage (permanent residents, marriage immigrants, and naturalized citizens) using the National Health Insurance Claims Database in 2011-2013 was established. Cases were defined as immigrants with new-onset depression. Controls were new-onset Korean patients with depression matched by age, sex, and Charlson comorbidity index in a 1:2 ratio. Appropriateness of care (AOC) was defined as visiting a clinic for depression management at least 3 times in the first 12 weeks and 4 times thereafter until 12 months post-cohort entry. RESULTS A total of 2,378 immigrants and 4,756 matched Korean patients were identified. Of the immigrants, 30.0% achieved AOC, in contrast to 38.7% of Koreans (p < .0001). Adjusting for possible covariates, AOC was less likely for immigrants (adjusted OR (aOR), 0.760; 95% CI: 0.670-0.863). Medical Aid (aOR, 2.309; 95% CI, 1.479-3.610), rural residence (aOR, 1.536; 95% CI, 1.054-2.237), the presence of a psychiatric comorbidity (aOR, 1.912; 95% CI, 1.484-2.463), and visiting a psychiatrist (aOR, 2.387; 95% CI, 1.821-3.125) were associated with an increased likelihood of AOC in immigrants. CONCLUSION Socioeconomic determinants included insurance type (Medical Aid and National Health Insurance), place of residence, psychiatric comorbid status, doctor specialty, easy access to medical services (clinic-based), and a SSRI-based treatment regimen. Those predictors should be taken into account when developing healthcare strategies for immigrants.
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Affiliation(s)
- Sohyun Jeong
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Cinoo Kang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Hyemin Cho
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Hee-Jin Kang
- Big Data Steering Department of National Health Insurance Service, Wonju, Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
- * E-mail:
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Curtis P, Thompson J, Fairbrother H. Migrant children within Europe: a systematic review of children's perspectives on their health experiences. Public Health 2018; 158:71-85. [PMID: 29627115 DOI: 10.1016/j.puhe.2018.01.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To review the extant literature to explore what is known about children's own perspectives on their health experiences, focussing on children and young people who have migrated into, and within, Europe. STUDY DESIGN A systematic review with narrative synthesis. METHODS A review of English language articles was performed in June 2016 using the following databases: MEDLINE, CINAHL, Cochrane and Web of Science. Included articles had to report data generated directly with children, up to 18 years of age, who had migrated across national borders into, or within, Europe during their own lifetimes. Extraction from articles was undertaken by all authors, and quality assessment of included reviews was performed using the Mixed Methods Appraisal Tool. RESULTS The articles in the final data set included research based on four broad areas: alcohol, smoking and substance use; diet, eating disorders and overweight; emotional, psychological and mental health issues; and children's views and experiences of health and health services. Most studies were cross-sectional analytic or incidence or prevalence studies. CONCLUSION There is a general lack of clarity in the literature regarding the reporting of children's own migration status. Children's voices are often subsumed within those of their adult parents or carers. There is a need to promote more child-focussed research which gives voice to migrant children to better understand the complex and multidimensional factors that contribute to their (ill)health.
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Affiliation(s)
- P Curtis
- The University of Sheffield, The School of Nursing & Midwifery, Barber House, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom.
| | - J Thompson
- The University of Sheffield, The School of Nursing & Midwifery, Barber House Annexe, 3a Clarkehouse Road, Sheffield S10 2LA, United Kingdom
| | - H Fairbrother
- The University of Sheffield, The School of Nursing & Midwifery, Barber House Annexe, 3a Clarkehouse Road, Sheffield S10 2LA, United Kingdom
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Mental Health in Immigrants Versus Native Population: A Systematic Review of the Literature. Arch Psychiatr Nurs 2017; 31:111-121. [PMID: 28104048 DOI: 10.1016/j.apnu.2016.07.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 11/22/2022]
Abstract
UNLABELLED The relationship between psychopathology and migration presents unresolved questions. OBJECTIVES To determine whether there is a higher incidence of mental illness among immigrants, to describe the nosologic differences between immigrant and native populations, and to identify the risk factors involved of immigration. METHODS A systematic review was conducted using the PubMed, Science Direct, ISI, Scopus, Psycinfo, Cochrane, and Cuiden databases. The search strategy was conducted using the MeSH thesaurus for the controlled terms "mental disorders," "mental health," "transients and migrants," "immigrants," and "epidemiology." The quality of the articles was analyzed by using the Equator Guidelines, following checklists according to the methodological design of the studies by two independent reviewers. RESULTS From a total of 817 studies found, 21 met the inclusion criteria. Out of the 21 studies selected, 13 showed a higher prevalence of mental illness. CONCLUSIONS Migration represents a major challenge, but it does not lead exclusively to mental distress. Immigrants experience more problems in depression, anxiety, and somatic disorders, pathologies related directly to the migration process and stress suffered. Resources should be oriented to primary and community care.
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Abstract
Violence has been shown to be a global challenge resulting in long-lasting social, medical, and mental health sequelae. In this article, we focus on massive social violence, such as war and civil war. Social suffering and mental health problems related to violence as a global public health problem can be tackled only with a holistic approach that addresses the specific region, culture and group and the limited resources available in most countries. Research that can give a reliable assessment of complex long-term outcomes is still largely missing, and can be seen as a major and complex challenge for future study.
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Affiliation(s)
- Thomas Wenzel
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18, Vienna A-1090, Austria.
| | - Hanna Kienzler
- Department of Social Science, Health and Medicine, King's College London, Strand, London WC2R 2LS, UK
| | - Andreas Wollmann
- Sigmund Freud University, Schnirchgasse 3A, Vienna A-1030, Austria
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Belhadj Kouider E, Koglin U, Petermann F. Emotional and behavioral problems in migrant children and adolescents in Europe: a systematic review. Eur Child Adolesc Psychiatry 2014; 23:373-91. [PMID: 24132833 DOI: 10.1007/s00787-013-0485-8] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
Based on findings of Stevens and Vollebergh [69], who analyzed cross-cultural topics, this review considers the current prevalence of emotional and behavioral problems of native children and adolescents in comparison with children with a migration background in European countries. 36 studies published from 2007 up to 2013 chosen from a systematic literature research were included and analyzed in their perspective design in detail. Previous studies showed great differences in their results: Especially in Germany, many studies compare the heterogeneous group of immigrant children with native children to analyze an ethnic minority or migration process effect. Only a British and Turkish study demonstrates the selection effect in migration. Most Dutch or British studies examined different ethnic groups, e.g. Turkish, Moroccan, Surinamese, Pakistani, Indian or Black migrant children and adolescents. Migrant childhood in Europe could be declared a risk in increasing internalizing problem behavior while the prevalent rate in externalizing problem behavior was comparable between native and migrant children. A migration status itself can often be postulated as a risk factor for children's mental condition, in particular migration in first generation. Furthermore, several major influence factors in migrant children's mental health could be pointed out, such as a low socio-economic status, a Non-European origin, an uncertain cultural identity of the parents, maternal harsh parenting or inadequate parental occupation, a minority status, the younger age, gender effects or a specific culture declaration in diseases.
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Affiliation(s)
- Esmahan Belhadj Kouider
- Center for Clinical Psychology and Rehabilitation, University Bremen, Grazer Str. 6, 28359, Bremen, Germany,
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Interethnische Analysen der Verteilungen psychischer Störungen bei Kindern und Jugendlichen in einer Inanspruchnahmepopulation. Prax Kinderpsychol Kinderpsychiatr 2014; 63:272-288. [PMID: 26444530 DOI: 10.13109/prkk.2014.63.4.272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Interethnic Analyses of Distributions in Children and Adolescents Mental Disorders in a Health Care Utilization The study examines ethnic differences in mental disorders in a child and adolescent psychiatry population in a major German city from 2007 to 2011 (N = 5,680). Risks of developing specific mental disorders were calculated. African migrant children and adolescents showed higher risk in traumatic stress and adjustment disorders (F 43 in ICD-10), the Asiatic group in dissociative disorders (F 44-45). Compared to other European migrants the German children and adolescents without migration background had a higher risk of affective disorders (F 3). Adolescents (N = 3,556) with Russian and Polish background had a higher risk of disorders induced by psychotropic substances (F 1). Turkish and Arabic adolescents had a 4- to 5-times increasing risk in schizophrenia as well as schizotypal or delusional disorders (F 2). In addition, mental disorders were influenced by gender and nationality. These study results suggest that a different vulnerability to specific mental disorders is associated to ethnicity.
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13
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Flink IJE, Jansen PW, Beirens TMJ, Tiemeier H, van IJzendoorn MH, Jaddoe VWV, Hofman A, Raat H. Differences in problem behaviour among ethnic minority and majority preschoolers in the Netherlands and the role of family functioning and parenting factors as mediators: the Generation R Study. BMC Public Health 2012; 12:1092. [PMID: 23253397 PMCID: PMC3577476 DOI: 10.1186/1471-2458-12-1092] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 11/23/2012] [Indexed: 11/10/2022] Open
Abstract
Background Studies have shown that, compared to native counterparts, preschoolers from ethnic minorities are at an increased risk of problem behaviour. Socio-economic factors only partly explain this increased risk. This study aimed to further unravel the differences in problem behaviour among ethnic minority and native preschoolers by examining the mediating role of family functioning and parenting factors. Methods We included 4,282 preschoolers participating in the Generation R Study, an ethnically-diverse cohort study with inclusion in early pregnancy. At child age 3 years, parents completed the Child Behavior Checklist (CBCL/1,5-5); information on demographics, socio-economic status and measures of family functioning (maternal psychopathology; general family functioning) and parenting (parenting stress; harsh parenting) were retrieved from questionnaires. CBCL Total Problems scores in each ethnic subgroup were compared with scores in the Dutch reference population. Mediation was evaluated using multivariate regression models. Results After adjustment for confounders, preschoolers from ethnic minorities were more likely to present problem behaviour than the Dutch subgroup (e.g. CBCL Total Problems Turkish subgroup (OR 7.0 (95% CI 4.9; 10.1)). When considering generational status, children of first generation immigrants were worse off than the second generation (P<0.01). Adjustment for socio-economic factors mediated the association between the ethnic minority status and child problem behaviour (e.g. attenuation in OR by 54.4% (P<0.05) from OR 5.1 (95% CI 2.8; 9.4) to OR 2.9 (95% CI 1.5; 5.6) in Cape Verdean subgroup). However, associations remained significant in most ethnic subgroups. A final adjustment for family functioning and parenting factors further attenuated the association (e.g. attenuation in OR by 55.5% (P<0.05) from OR 2.2 (95% CI 1.3; 4.4) to OR 1.5 (95% CI 1.0; 2.4) in European other subgroup). Conclusions This study showed that preschoolers from ethnic minorities and particularly children of first generation immigrants are at an increased risk of problem behaviour compared to children born to a Dutch mother. Although socio-economic factors were found to partly explain the association between the ethnic minority status and child problem behaviour, a similar part was explained by family functioning and parenting factors. Considering these findings, it is important for health care workers to also be attentive to symptoms of parental psychopathology (e.g. depression), poor family functioning, high levels of parenting stress or harsh parenting in first and second generation immigrants with young children.
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Affiliation(s)
- Ilse J E Flink
- The Generation R study group, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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De Luca G, Ponzo M, Andrés AR. Health care utilization by immigrants in Italy. ACTA ACUST UNITED AC 2012; 13:1-31. [PMID: 23239018 DOI: 10.1007/s10754-012-9119-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 11/20/2012] [Indexed: 11/25/2022]
Abstract
Healthcare utilization studies show how well documented disparities between migrants and non-migrants. Reducing such disparities is a major goal in European countries. However, healthcare utilization among Italian immigrants is under-studied. The objective of this study is to explore differences in healthcare use between immigrant and native Italians. Cross-sectional study using the latest available (2004/2005) Italian Health Conditions Survey. We estimated separate hurdle binomial negative regression models for GP, specialist, and telephone consultations and a logit model for emergency room (ER) use. We used logistic regression and zero-truncated negative binomial regression to model the zero (contact decision) and count processes (frequency decisions) respectively. Adjusting for risk factors, immigrants are significantly less likely to use healthcare services with 2.4 and 2.7 % lower utilization probability for specialist and telephone consultations, respectively. First- and second-generation immigrants' probability for specialist and telephone contact is significantly lower than natives'. Immigrants, ceteris paribus, have a much higher probability of using ERs than natives (0.7 %). First-generation immigrants show a higher probability of visiting ERs (1 %). GP visits show no significant difference. In conclusion Italian immigrants are much less likely to use specialist healthcare and medical telephone consultations than natives but more likely to use ERs. Hence, we report an over-use of ERs and under-utilization of preventive care among immigrants. We recommend improved health policies for immigrants: promotion of better information dissemination among them, simplification of organizational procedures, better communications between providers and immigrants, and an increased supply of health services for the most disadvantaged populations.
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Affiliation(s)
- Giuliana De Luca
- Department of Economics and Statistics, University of Calabria, via Ponte Bucci, 87036, Arcavacata di Rende, CS, Italy.
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The health of migrant children in Switzerland. Int J Public Health 2012; 57:659-71. [PMID: 22699954 DOI: 10.1007/s00038-012-0375-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 05/19/2012] [Accepted: 05/21/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE Over 22 % of children and adolescents living in Switzerland have a migrant background. The aim of this systematic literature review is to give an overview of health needs of paediatric migrants in Switzerland. METHODS Three databases (Embase, Medline, Global health) were systematically searched for quantitative primary research on the health outcomes of migrant minors (<18-year old) in Switzerland, including articles published since 2000 in French, German, Italian or English. Citation chasing and search of non-indexed literature was also performed. RESULTS Thirty publications were identified. Compared to their Swiss peers, migrant children had higher hospitalisation (+40 %) and intensive care admission rates, more dental cavities, twice the odds of being obese, and migrant adolescents seemed more frequently affected by psychological problems and twice as often requesting abortions. Certain infectious diseases (tuberculosis, intestinal parasites, H. pylori infection, Hepatitis A) were more prevalent. Increased neonatal and infant mortality rates were found in Turkish and African babies. CONCLUSION Children of migrants may have distinct health needs. They should benefit from migrant paediatric care and health promotion activities that recognise these.
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Lin KC, Huang HC, Bai YM, Kuo PC. Lifetime residential mobility history and self-rated health at midlife. J Epidemiol 2011; 22:113-22. [PMID: 22197767 PMCID: PMC3798589 DOI: 10.2188/jea.je20110055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Little research focuses on the influence of lifetime residential mobility on health at midlife. We used a national survey of participant recall of residential mobility to assess this issue and explore the mediating and moderating effects of personal and environmental context. Methods In March 2010, we collected data from people in Taiwan aged 40 to 60 years. Based on the household registration system, data were collected using the population proportional-to-size sampling method and a computer-assisted telephone interview. A total of 2834 participants completed the interview. Based on the 3490 registered households, the overall response rate was 81.2%. Results The mean cumulative frequency of geographic relocation (CFGR) was 3.06 ± 2.78 times and ranged from 0 to 21. After carefully adjusting for the heterogeneity of demographic and socioeconomic propensity, total CFGR was significantly positively associated with negative self-rated mental (odds ratio [OR] and 95% CI for increase per time: 1.06, 1.02–1.16) and physical (OR and 95% CI for increase per time: 1.16, 1.05–1.26) health. Social network support lessened the impact of total CFGR on self-rated mental health. In addition to the primary effect, the interaction (residential environmental satisfaction × total CFGR) significantly moderated negative mental health and negative physical health. Conclusions Lifetime residential mobility history independently influenced midlife health. Social network support and satisfaction with the residential environment in past and current living places further mediated or moderated midlife health. Findings from these different perspectives offer insights for future medical care projects and epidemiologic studies.
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Affiliation(s)
- Kuan-Chia Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
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Glaesmer H, Wittig U, Braehler E, Martin A, Mewes R, Rief W. Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany. Int J Public Health 2010; 56:541-8. [PMID: 21038108 DOI: 10.1007/s00038-010-0205-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 09/08/2010] [Accepted: 09/24/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES There are contradictory findings on health care utilization (HCU) of immigrants compared to native-born populations. Our study focuses on this topic using a population-based approach and differentiates generational cohorts of immigrants. METHODS In a representative population survey in Germany (N = 2,510), immigrant background/generational cohort and HCU in the preceding 12 months were screened by means of self-rating instruments. RESULTS 11.1% (7.0% first and 4.1% second generation) of the sample are immigrants. No differences have been detect with regard to subjective state of health, satisfaction with life and with health and functional disabilities. First generation immigrants contacted a medical specialist less likely, but they more frequently use general practitioners (GPs) than the native-born Germans and the second generation immigrants. CONCLUSIONS First generation immigrants show remarkable differences in HCU compared to the native-born Germans and the second generation immigrants. Their HCU seems to be focused on primary care, and access to secondary care might be complicated. It seems relevant to especially pay attention to HCU of first generation immigrants and to support equal access to care for this subgroup.
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Affiliation(s)
- Heide Glaesmer
- Department of Medical Psychology and Sociology, University of Leipzig, Leipzig, Germany.
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Pavlova B, Uher R, Dragomirecka E, Papezova H. Trends in hospital admissions for eating disorders in a country undergoing a socio-cultural transition, the Czech Republic 1981-2005. Soc Psychiatry Psychiatr Epidemiol 2010; 45:541-50. [PMID: 19618094 DOI: 10.1007/s00127-009-0092-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 07/02/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test the hypothesis that the socio-cultural transition in the 1990s in Eastern Europe was associated with an increase in admissions for eating disorders (ED). METHOD Cases of ICD-9 and ICD-10 ED in 1981, 1986 and 1992-2005 and first admissions for ICD-10 anorexia nervosa (AN) in 1994-2005 were retrieved from the Czech national register of hospital admissions. Age- and sex-adjusted admission rates (per 100,000) were calculated and time trends tested by Poisson regression. RESULTS The admission rate for ED in females aged 10-39 quadrupled from 2.6 (95% CI 2.1-3.0) in 1981 to 10.6 (95% CI 9.8-11.5) in 2001, and remained elevated till 2005. The rate of first-time admissions for AN in 10- to 39-old females increased from 4.5 (95% CI 3.6-5.4) in 1994 to 7.5 (95% CI 6.3-8.6) in 1999, followed by a non-significant decrease. CONCLUSION Temporal association of an increase in admissions with socio-cultural transition suggests that risk of severe ED including AN is culture-dependent.
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Affiliation(s)
- Barbara Pavlova
- Department of Psychology, Institute of Psychiatry, PO78, 4 Windsor Walk, London, SE5 8AF, UK.
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Gieling M, Vollebergh W, van Dorsselaer S. Ethnic density in school classes and adolescent mental health. Soc Psychiatry Psychiatr Epidemiol 2010; 45:639-46. [PMID: 19655079 PMCID: PMC2874053 DOI: 10.1007/s00127-009-0105-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 07/15/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The present study set out to examine the association between ethnic composition of school classes and prevalence of internalising and externalising problem behaviour among ethnic minority and majority students. METHODS Data were derived from the Dutch 2002 Health Behaviour in School-aged Children (HBSC) survey, a nationally representative cross-sectional study with a total of 5,730 adolescents, aged 11-18 and attending secondary school, of which 931 belong to ethnic minority groups. The data were analysed using a multilevel regression model. RESULTS The study revealed that, after taking individual characteristics like age, gender, educational level and family affluence into account, ethnic minority students on average report higher levels of externalising but not internalising problems. Ethnic density on the level of school classes modified this difference, as a negative association between the proportion ethnic minority students in class and externalising problem behaviour was found, but only for ethnic minority students. No effect of ethnic composition was found with respect to internalising problem behaviour. CONCLUSION The data revealed that ethnic minority students report higher levels of externalising problem behaviour, but only in classes with a minority of ethnic minority students and not in classes with a culturally diverse composition. This points towards a possible beneficial effect of a more culturally diverse environment for minority students. Majority students appeared to be insensitive for the ethnic density effect. Future studies should investigate the role of the ethnic composition of the school class more in-depth.
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Affiliation(s)
- Maike Gieling
- Faculty of Social and Behavioural Sciences, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht, The Netherlands.
| | - Wilma Vollebergh
- Faculty of Social and Behavioural Sciences, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Da Costakade 45, 3500 AS Utrecht, The Netherlands
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