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Mamudu L, Chiangong J, Curry M, McEligot AJ, Mamudu HM, Williams F. The influence of nativity/birthplace, neighborhood cohesion, and duration lived in the neighborhood on psychological distress. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2024; 17:100798. [PMID: 38855351 PMCID: PMC11156170 DOI: 10.1016/j.jadr.2024.100798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
Introduction Nativity/birthplace and neighborhood cohesion are potential contributing factors to psychological distress. This study explores the impact of nativity/birthplace and neighborhood cohesion on moderate-severe psychological distress among United States (US) adults, considering the duration lived in a neighborhood. Methods Using the 2013-2018 National Health Interview Survey data, we conducted a stratified analysis based on years lived in the neighborhood (≤10 years [n = 96,175] and >10 years [n = 68,187]). Bivariate chi-square tests and multivariable logistic regression models were used to assess the statistical differences and associations between moderate-severe psychological distress and nativity/birthplace, and neighborhood cohesion, while adjusting for other covariates. Results Individuals with 10 years or less of residence reported higher levels of moderate-severe psychological distress than those with more than 10 years (22.3 % vs. 18.1 %). Low or medium neighborhood cohesion, regardless of duration of residence, was associated with significantly higher odds of moderate-severe psychological distress compared to high cohesion. Foreign-born individuals had higher odds of psychological distress after more than 10 years in a neighborhood, although this difference was not statistically significant. However, they had lower odds of psychological distress after 10 years or less in the neighborhood compared to US-born individuals. Similarly, the interaction of foreign-born status and 10 years or less of residence in a neighborhood showed decreased odds of psychological distress. Conclusions These findings underscore the importance of strong social cohesion in neighborhoods for positive mental well-being. Establishing community initiatives to enhance neighborhood social cohesion is crucial.
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Affiliation(s)
- Lohuwa Mamudu
- Department of Public Health, College of Health and Human Sciences, California State University, Fullerton, CA, USA
| | - Jolyna Chiangong
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Michael Curry
- Information Management Services Inc., Calverton, MD, USA
| | - Archana J. McEligot
- Department of Public Health, College of Health and Human Sciences, California State University, Fullerton, CA, USA
| | - Hadii M. Mamudu
- Center for Cardiovascular Risk Research, East Tennessee State University, Johnson City, TN, USA
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Ormiston CK, Mamudu L, McNeel TS, Wang Z, Buckman DW, Williams F. Association of depression and self-reported health status by birthplace and citizenship status: Results from the 2010-2018 National Health Interview Survey. J Affect Disord 2024; 361:157-164. [PMID: 38851433 DOI: 10.1016/j.jad.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 04/16/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Self-reported health (SRH) is an important indicator of mental health outcomes. More information, however, is needed on whether this association varies by birthplace (defined as US-born or non-US-born) and citizenship status (i.e., non-US-born citizen, non-US citizen, and US-born citizen). METHODS We examined the associations between SRH and depression among non-US-born US citizens, non-US citizens, and US-born citizens aged 18 years and older using weighted cross-sectional data from the 2010-2018 National Health Interview Survey (n = 139,884). Logistic regression models were used to assess the association between depression and SRH by citizenship status, adjusting for covariates. RESULTS US-born citizens reported the highest prevalence of depression (40.3 %), and non-US-born citizens reported the highest prevalence of poor/fair SRH (14.5 %). Individuals with fair/poor SRH had a significantly increased likelihood of depression relative to those with good/very good/excellent for non-US-born US citizens (Adjusted Odds Ratio [AOR] = 2.42, 95 % Confidence Interval [95 % CI] = 2.04-2.88), non-US citizens (AOR = 2.80, 95 % CI = 2.31-3.40), and US-born citizens (AOR = 2.31, CI = 2.18-2.45). LIMITATIONS The study is cross-sectional, reducing the strength of determining causal relationships. Also, there is a possible response bias due to the self-reported nature of the data. CONCLUSIONS Our study indicates that fair/poor SRH is significantly associated with an increased likelihood of depression regardless of an individual citizenship status. Additionally, immigrants with fair/poor SRH had higher increased odds of depression. Therefore, mental healthcare interventions tailored for immigrants can reduce mental health problems and disparities among immigrants.
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Affiliation(s)
- Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, CA, USA
| | | | - Zhuoqiao Wang
- Information Management Services, Inc., Calverton, MD, USA
| | | | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.
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Ormiston CK, Villalobos K, Montiel Ishino FA, Williams F. Association Between Discrimination and Depressive Symptoms Among Hispanic or Latino Adults During the COVID-19 Pandemic: Cross-Sectional Study. JMIR Form Res 2024; 8:e48076. [PMID: 38843512 PMCID: PMC11190619 DOI: 10.2196/48076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19 pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding existing disparities and worsening mental health. OBJECTIVE This study aims to examine the association between discrimination and depressive symptoms during the COVID-19 pandemic among a national sample of Hispanic and Latino adults. METHODS Data from a 116-item web-based nationally distributed survey from May 2021 to January 2022 were analyzed. The sample (N=1181) was restricted to Hispanic or Latino (Mexican or Mexican American, Puerto Rican; Cuban or Cuban American, Central or South American, and Dominican or another Hispanic or Latino ethnicity) adults. Depression symptoms were assessed using the 2-item Patient Health Questionnaire. Discrimination was assessed using the 5-item Everyday Discrimination Scale. A multinomial logistic regression with a block entry model was used to assess the relationship between discrimination and the likelihood of depressive symptoms, as well as examine how controls and covariates affected the relationship of interest. RESULTS Mexican or Mexican American adults comprised the largest proportion of the sample (533/1181, 45.13%), followed by Central or South American (204/1181, 17.3%), Puerto Rican (189/1181, 16%), Dominican or another Hispanic or Latino ethnicity (172/1181, 14.6%), and Cuban or Cuban American (83/1181, 7.03%). Approximately 31.26% (367/1181) of the sample had depressive symptoms. Regarding discrimination, 54.56% (634/1181) reported experiencing some form of discrimination. Compared with those who did not experience discrimination, those who experienced discrimination had almost 230% higher odds of depressive symptoms (adjusted odds ratio [AOR] 3.31, 95% CI 2.42-4.54). Also, we observed that sociodemographic factors such as age and gender were significant. Compared with participants aged 56 years and older, participants aged 18-35 years and those aged 36-55 years had increased odds of having depressive symptoms (AOR 3.83, 95% CI 2.13-6.90 and AOR 3.10, 95% CI 1.74-5.51, respectively). Women had higher odds of having depressive symptoms (AOR 1.67, 95% CI 1.23-2.30) than men. Respondents with an annual income of less than US $25,000 (AOR 2.14, 95% CI 1.34-3.41) and US $25,000 to less than US $35,000 (AOR 1.89, 95% CI 1.17-3.06) had higher odds of depressive symptoms than those with an annual income of US $50,000 to less than US $75,000. CONCLUSIONS Our findings provide significant importance especially when considering the compounding, numerous socioeconomic challenges stemming from the pandemic that disproportionately impact the Hispanic and Latino communities. These challenges include rising xenophobia and tensions against immigrants, inadequate access to mental health resources for Hispanic and Latino individuals, and existing hesitations toward seeking mental health services among this population. Ultimately, these findings can serve as a foundation for promoting health equity.
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Affiliation(s)
- Cameron K Ormiston
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kevin Villalobos
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | | | - Faustine Williams
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
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Rook GAW. Evolution and the critical role of the microbiota in the reduced mental and physical health associated with low socioeconomic status (SES). Neurosci Biobehav Rev 2024; 161:105653. [PMID: 38582194 DOI: 10.1016/j.neubiorev.2024.105653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
The evolution of the gut-microbiota-brain axis in animals reveals that microbial inputs influence metabolism, the regulation of inflammation and the development of organs, including the brain. Inflammatory, neurodegenerative and psychiatric disorders are more prevalent in people of low socioeconomic status (SES). Many aspects of low SES reduce exposure to the microbial inputs on which we are in a state of evolved dependence, whereas the lifestyle of wealthy citizens maintains these exposures. This partially explains the health deficit of low SES, so focussing on our evolutionary history and on environmental and lifestyle factors that distort microbial exposures might help to mitigate that deficit. But the human microbiota is complex and we have poor understanding of its functions at the microbial and mechanistic levels, and in the brain. Perhaps its composition is more flexible than the microbiota of animals that have restricted habitats and less diverse diets? These uncertainties are discussed in relation to the encouraging but frustrating results of attempts to treat psychiatric disorders by modulating the microbiota.
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Affiliation(s)
- Graham A W Rook
- Centre for Clinical Microbiology, Department of infection, UCL (University College London), London, UK.
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Handiso DW, Paul E, Boyle JA, Shawyer F, Meadows G, Enticott JC. Trends and determinants of mental illness in humanitarian migrants resettled in Australia: Analysis of longitudinal data. Int J Ment Health Nurs 2024. [PMID: 38651241 DOI: 10.1111/inm.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/13/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
Given the frequent exposure of humanitarian migrants to traumatic or stressful circumstances, there exists a potential predisposition to mental illness. Our objective was to pinpoint the trends and determinants of mental illness among humanitarian migrants resettled in Australia. This study considered five waves of longitudinal data involving humanitarian migrants resettled in Australia. Post-traumatic stress disorder (PTSD) and psychological distress were assessed using PTSD-8 and Kessler-6 screening tools. Through a Generalised Linear Mixed model (GLMM), variables displaying a 95% CI that excluded the value of 1.0 for the odds ratio were identified as associated factors for both PTSD and elevated psychological distress. The selection of multivariable covariates was guided by causal loop diagrams and least absolute shrinkage and selection operators methods. At baseline, there were 2399 humanitarian migrants with 1881 retained and at the fifth yearly wave; the response rate was 78.4%. PTSD prevalence decreased from 33.3% (95% CI: 31.4-35.3) at baseline to 28.3% (95% CI: 26.2-30.5) at year 5. Elevated psychological distress persisted across all waves: 17.1% (95% CI: 15.5-18.6) at baseline and 17.1% (95% CI: 15.3-18.9) at year 5. Across the five waves, 34.0% of humanitarian migrants met screening criteria for mental illness, either PTSD or elevated psychological distress. In the multivariate model, factors associated with PTSD were loneliness (AOR 1.5, 95% CI: 1.3-1.8), discrimination (AOR 1.6: 1.2-2.1), temporary housing contract (AOR 3.7: 2.1-6.7), financial hardship (AOR 2.2:1.4-3.6) and chronic health conditions (AOR 1.3: 1.1-1.5), whereas the associated factors for elevated psychological distress were loneliness (AOR 1.8: 1.5-2.2), discrimination (AOR 1.7: 1.3-2.2) and short-term lease housing (AOR 1.6: 1.0-1.7). The prevalence, persistence and consequential burden of mental illness within this demographic underscore the urgent need for targeted social and healthcare policies. These policies should aim to mitigate modifiable risk factors, thereby alleviating the significant impact of mental health challenges on this population.
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Affiliation(s)
- Demelash Woldeyohannes Handiso
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Eldho Paul
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
| | - Graham Meadows
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
- Mental Health Program, Monash Health, Melbourne, Victoria, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Joanne C Enticott
- Monash Centre for Health Research and Implementation, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
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Byhoff E, Dinh DH, Lucas JA, Marino M, Heintzman J. Mental Health Care Use by Ethnicity and Preferred Language in a National Cohort of Community Health Center Patients. Psychiatr Serv 2024; 75:363-368. [PMID: 37880967 PMCID: PMC10984775 DOI: 10.1176/appi.ps.20220585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Disparities in U.S. mental health care by race and ethnicity have long been documented. The authors sought to compare specialty mental health service use among non-Hispanic White, English-preferring Hispanic, and Spanish-preferring Hispanic patients who accessed care in community health centers (CHCs). METHODS Retrospective electronic medical records data were extracted for patients ages ≥18 years who received care in 2012-2020 at a national CHC network. Zero-inflated Poisson regression models were used to estimate the likelihood of receiving mental health services, which was compared with expected annual rates of mental health service use. RESULTS Of the 1,498,655 patients who received care at a CHC during the study, 14.4% (N=215,098) received any specialty mental health services. English- and Spanish-preferring Hispanic patients were less likely to have had a mental health visit (OR=0.69, 95% CI=0.61-0.77, and OR=0.65, 95% CI=0.54-0.78, respectively). Compared with non-Hispanic White patients, Spanish-preferring Hispanic patients had an estimated annualized rate of 0.59 (95% CI=0.46-0.76) mental health visits. CONCLUSIONS Among patients who were likely to receive specialty mental health services, Spanish-preferring patients had a significantly lower rate of mental health care use. Although overall access to mental health care is improving, unequal access to recurring specialty mental health care remains among patients who do not prefer to use English.
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Affiliation(s)
- Elena Byhoff
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman)
| | - Dang H Dinh
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman)
| | - Jennifer A Lucas
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman)
| | - Miguel Marino
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman)
| | - John Heintzman
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman)
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Adzrago D, Walker TJ, Williams F. Reliability and validity of the Patient Health Questionnaire-4 scale and its subscales of depression and anxiety among US adults based on nativity. BMC Psychiatry 2024; 24:213. [PMID: 38500115 PMCID: PMC10949792 DOI: 10.1186/s12888-024-05665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The burdens of anxiety and depression symptoms have significantly increased in the general US population, especially during this COVID-19 epidemiological crisis. The first step in an effective treatment for anxiety and depression disorders is screening. The Patient Health Questionnaire-4 (PHQ-4, a 4-item measure of anxiety/depression) and its subscales (PHQ-2 [a 2-item measure of depression] and Generalized Anxiety Disorder [GAD-2, a 2-item measure of anxiety]) are brief but effective mass screening instruments for anxiety and depression symptoms in general populations. However, little to no study examined the psychometric properties (i.e., reliability and validity) of the PHQ-4 and its subscales (PHQ-2 and GAD-2) in the general US adult population or based on US nativity (i.e., foreign-born vs. the US-born). We evaluated the psychometric properties of the PHQ-4 and its subscales in US adults, as well as the psychometric equivalence of the PHQ-4 scale based on nativity. METHODS We conducted a cross-sectional survey of 5,140 adults aged ≥ 18 years. We examined the factorial validity and dimensionality of the PHQ-4 with confirmatory factor analysis (CFA). A multiple-group confirmatory factor analysis (MCFA) was used to evaluate the comparability of the PHQ-4 across nativity groups. Reliability indices were assessed. Also, the scales' construct validities were assessed by examining the associations of both the PHQ-4 and its subscales' scores with the sociodemographic characteristics and the 3-item UCLA Loneliness scale. RESULTS The internal consistencies were high for the PHQ-4 scale (α = 0.92) and its subscales of PHQ-2 (α = 0.86) and GAD-2 (α = 0.90). The CFA fit indices showed evidence for the two-factor structure of the PHQ-4. The two factors (i.e., anxiety and depression) were significantly correlated (r = 0.92). The MCFA demonstrated measurement invariance of the PHQ-4 across the nativity groups, but the model fits the data better in the foreign-born group. There were significant associations of the PHQ-4 scale and its subscales' scores with the sociodemographic characteristics and the UCLA Loneliness scale (all p < 0.001). CONCLUSIONS The PHQ-4 and its subscales are reliable and valid measures to screen anxiety and depression symptoms in the general US adult population, especially in foreign-born individuals during the COVID-19 pandemic.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, 20852, Rockville, MD, USA.
| | - Timothy J Walker
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, 20852, Rockville, MD, USA.
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Zhou S, Ogunjesa BA, Raj M. Mental Health Outcomes of Immigrant- and US-Born Caregivers: California Health Interview Survey, 2019-2020. Am J Public Health 2024; 114:189-199. [PMID: 38354351 PMCID: PMC10916737 DOI: 10.2105/ajph.2023.307396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 02/16/2024]
Abstract
Objectives. To compare the mental health outcomes of US-born with immigrant caregivers of adult care recipients. Methods. We conducted a cross-sectional secondary analysis of the 2019 California Health Interview Survey (CHIS), administered via web or telephone to 22 152 participants between September and December 2019. We characterized (1) caregivers and noncaregivers, and (2) US-born versus immigrant caregivers. Then, we estimated and compared (3) the relationship between caregiving status and severe psychological distress among US-born and immigrant respondents, and (4) correlates of severe psychological distress among US-born and immigrant respondents. Results. Caregivers were more likely than noncaregivers to report severe psychological distress (P < .05). Immigrant caregivers residing separately from their care recipient were significantly more likely to experience severe psychological distress (odds ratio = 3.76; P < .01). Conclusions. US-born and immigrant caregivers may experience different risk factors for psychological distress associated with caregiving. Clinical and community resources should be tailored to caregivers' distinct needs with consideration of how access to resources (e.g., language), circumstances (e.g., acculturation), and cultural norms (e.g., filial piety) may be associated with exacerbation of psychological distress among immigrants. (Am J Public Health. 2024;114(S2):S189-S199. https://doi.org/10.2105/AJPH.2023.307396).
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Affiliation(s)
- Sasha Zhou
- Sasha Zhou is with the Department of Public Health, Wayne State University, Detroit, MI. Minakshi Raj is with and Babatope Ayokunle Ogunjesa is a doctoral student in the College of Applied Health Sciences, University of Illinois, Urbana-Champaign
| | - Babatope Ayokunle Ogunjesa
- Sasha Zhou is with the Department of Public Health, Wayne State University, Detroit, MI. Minakshi Raj is with and Babatope Ayokunle Ogunjesa is a doctoral student in the College of Applied Health Sciences, University of Illinois, Urbana-Champaign
| | - Minakshi Raj
- Sasha Zhou is with the Department of Public Health, Wayne State University, Detroit, MI. Minakshi Raj is with and Babatope Ayokunle Ogunjesa is a doctoral student in the College of Applied Health Sciences, University of Illinois, Urbana-Champaign
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Slobodin O, Shorer M, Friedman-Zeltzer G, Fennig S. Selective mutism in immigrant families: An ecocultural perspective. Transcult Psychiatry 2024; 61:15-29. [PMID: 37814531 DOI: 10.1177/13634615231202095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Although the diagnosis of selective mutism (SM) is more prevalent among immigrant children, the link between the disorder and an immigration background has been elusive. Guided by ecocultural models of development, the current study aimed to construct a theory-based description of SM while considering individual, family, and contextual risk factors. Participants were 78 children with SM (38.4% with an immigration background), and 247 typically developed children (18.2% with an immigration background). Consistent with previous studies, our results suggest that anxiety was the most important predictor of SM symptoms, above and beyond immigration background. Immigration, especially if coupled with bilingual status and low family income, predicted increased levels of SM symptoms. Identifying multi-level predictors of SM may help researchers and clinicians to improve early identification and treatment of SM in culturally and linguistically diverse children.
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Affiliation(s)
- Ortal Slobodin
- School of Education, Ben-Gurion University, Beer-Sheva, Israel
| | - Maayan Shorer
- Department of Clinical Psychology and the Lior Tzfaty Mental Pain Center, Ruppin Academic Center, Emek Heffer, Israel
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | | | - Silvana Fennig
- Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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Vu C, C Arcaya M, Kawachi I, Williams D. The mental health toll of the Great Migration: a comparison of mental health outcomes among descendants of African American migrators. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02605-x. [PMID: 38231395 DOI: 10.1007/s00127-023-02605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION Research is beginning to examine the health outcomes of migrators of the Great Migration, a movement of up to eight million African Americans from the South to the North and West during the twentieth century. However, sparse evidence exists studying the health outcomes of the descendants of Great Migration movers. The aim for this study was to compare the lifetime prevalence of mental health disorders by migration status. METHODS We used a sample of 3183 African American adults from the National Survey of American Life (2001-2003). Using birthplaces of participants and their mothers, we classified adults as (1) Southern stayers, (2) migrators to the South, (3) migrators to the North or (4) Northern stayers. The outcomes were lifetime prevalence of any mental health, mood, anxiety, and substance use disorders. We used weighted log-Poisson regression models and adjusted for demographic characteristics and socioeconomic status. RESULTS Migrators to the North and Northern stayers had higher risks of any lifetime mental health, mood, anxiety, and substance use disorders compared to Southern stayers in the adjusted models. Migrators to the North and Northern stayers were more likely to report perceived discrimination. CONCLUSION This study suggests that migrating families to the North may have experienced mental health adversities.
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Affiliation(s)
- Cecilia Vu
- Harvard TH Chan School of Public Heath, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Mariana C Arcaya
- Department of Urban Studies at Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02138, USA
| | - Ichiro Kawachi
- Harvard TH Chan School of Public Heath, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - David Williams
- Harvard TH Chan School of Public Heath, Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA
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Esie P, Bates LM. At the intersection of race and immigration: a comprehensive review of depression and related symptoms within the US Black population. Epidemiol Rev 2023; 45:105-126. [PMID: 37310121 DOI: 10.1093/epirev/mxad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/09/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
Although the literature on the differences between Black people and White people in terms of differences in major depressive disorder and related self-reported symptoms is robust, less robust is the literature on how these outcomes are patterned within the US Black population and why differences exist. Given increased ethnic diversity of Black Americans due to increases in immigration, continued aggregation may mask differences between Black ethnic-immigrant groups and Black Americans with more distant ancestral ties to Africa (African Americans). The purpose of this narrative review was to comprehensively synthesize the literature on depression and related symptoms within the US Black population across immigration- and ethnicity-related domains and provide a summary of mechanisms proposed to explain variation. Findings revealed substantial variation in the presence of these outcomes within the US Black population by nativity, region of birth, age at immigration, and Caribbean ethnic origin. Racial context and racial socialization were identified as important, promising mechanisms for better understanding variations by region of birth and among those born or socialized in the United States, respectively. Findings warrant data collection efforts and measurement innovation to better account for within-racial differences in outcomes under study. A greater appreciation of the growing ethnic-immigrant diversity within the US Black population may improve understanding of how racism differentially functions as a cause of depression and related symptoms within this group.
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Affiliation(s)
- Precious Esie
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States
| | - Lisa M Bates
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States
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Colón LT. Coloniality and Ethnic Variation in Psychological Distress Among US Latinx Immigrants. J Immigr Minor Health 2023; 25:1374-1381. [PMID: 37097412 DOI: 10.1007/s10903-023-01481-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/26/2023]
Abstract
To address ethnic variation and potential cross-cultural measurement error in diagnostic criteria, this study extends on the racialized ethnicities framework to examine how Latinxs' self-reported psychological distress differ among ethnic groups. Utilizing data from the National Health Interview Survey, logistic regression models and partial proportional odds models assessed differences in likelihood of self-reporting frequent anxiety, depression, and psychological distress among Mexican, Puerto Rican, Cuban, Dominican, and Central and South American immigrants. Membership in Caribbean Latinx ethnic groups, and the Puerto Rican ethnic group in particular, was significantly associated with higher predicted probabilities of frequent anxious and depressive feelings, and severe psychological distress, relative to membership in non-Caribbean Latinx ethnic groups. This work highlights the need for research on Latinxs to disaggregate among ethnic groups, and proposes the existence of a gradient of exposure to the psychosocial consequences of US coloniality that might explain some of these variations.
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Talham CJ, Williams F. Household food insecurity during the COVID-19 pandemic is associated with anxiety and depression among US- and foreign-born adults: Findings from a nationwide survey. J Affect Disord 2023; 336:126-132. [PMID: 37244545 PMCID: PMC10211252 DOI: 10.1016/j.jad.2023.05.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic led to significant disruptions to household food security with as many as 10.5 % of US households experiencing food insecurity during 2020. Food insecurity is associated with psychological distress including depression and anxiety. However, to the best of our knowledge, no study has analyzed the association between COVID-19 food insecurity and poor mental health outcomes by place of birth. The Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases national survey assessed the physical and psychosocial effects of social and physical distancing during the COVID-19 pandemic among a diverse population of US- and foreign-born adults. Multivariable logistic regression was used to assess the relationship between place of birth and food security status and anxiety (N = 4817) and depression (N = 4848) among US- and foreign-born individuals. Stratified models subsequently analyzed the associations between food security and poor mental health among US- and foreign-born populations separately. Model controls included sociodemographic and socioeconomic factors. Low and very low household food security were associated with greater odds of both anxiety (low: odds ratio (OR) [95 % confidence interval (CI)] = 2.07 [1.42-3.03]; very low: OR [95 % CI] = 3.35 [2.15-5.21]) and depression (low: OR [95 % CI] = 1.92 [1.33-2.78]; very low: OR [95 % CI] = 2.36 [1.52-3.65]). However, this relationship was attenuated among foreign-born individuals compared to US-born individuals in the stratified models. All models found a dose-response relationship between increasing levels of food insecurity and anxiety and depressive symptoms. Further research is needed to explore the factors that attenuated the relationship between food insecurity and poor mental health among foreign-born individuals.
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Affiliation(s)
- Charlotte J Talham
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike no. T10, Rockville, MD 20852, United States of America
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike no. T10, Rockville, MD 20852, United States of America.
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Smith ML, Seegulam V, Szentkúti P, Horváth-Puhó E, Galea S, Lash TL, Rosellini AJ, Schnurr PP, Sørensen HT, Gradus JL. Risk of psychopathology following traumatic events among immigrants and native-born persons in Denmark. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1305-1316. [PMID: 36449069 DOI: 10.1007/s00127-022-02391-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/14/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE Immigrants may have increased risk of mental disorders compared with native-born persons. We aimed to expand the limited research on immigrants' posttraumatic psychopathology related to traumatic experiences in their country of resettlement. METHODS We obtained data from a cohort of Danish residents with ≥ 1 traumatic event recorded in health and administrative national registries during 1994-2016. We calculated risks of posttraumatic stress disorder (PTSD), depression, and substance use disorders (SUD) within 5 years post-trauma among native-born Danes and immigrants who had been in Denmark for ≥ 10 years at the time of their index trauma (including immigrants overall and immigrants from specific regions). Risks were compared via age- and sex-standardized risk ratios (SRR) with 95% confidence intervals (CI). We restricted to persons with no record of the disorder under investigation in the 10 years pre-trauma, and stratified by non-interpersonal (e.g., transport accidents) versus interpersonal trauma (e.g., assaults). RESULTS Following non-interpersonal trauma, immigrants were more likely than native-born Danes to be diagnosed with PTSD (SRR = 5.2, 95% CI 4.6, 5.9), about as likely to be diagnosed with depression (SRR = 0.98, 95% CI 0.92, 1.1), and less likely to be diagnosed with SUD (SRR = 0.89, 95% CI 0.82, 0.95). Results were similar following interpersonal trauma, except the SRR for PTSD was reduced in magnitude (SRR = 3.0, 95% CI 1.7, 5.4). There were differences by region of birth. CONCLUSION Immigrants to Denmark have higher risk of PTSD following traumatic experiences than do native-born Danes, possibly due to the combined influence of adverse pre-, peri-, and/or post-migration experiences.
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Affiliation(s)
- Meghan L Smith
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Vijaya Seegulam
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Péter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Sandro Galea
- School of Public Health, Boston University, 715 Albany St., Boston, MA, 02118, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Paula P Schnurr
- National Center for PTSD Executive Division, White River Junction, VT, USA
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
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Errazuriz A, Schmidt K, Valenzuela P, Pino R, Jones PB. Common mental disorders in Peruvian immigrant in Chile: a comparison with the host population. BMC Public Health 2023; 23:1274. [PMID: 37391769 PMCID: PMC10314508 DOI: 10.1186/s12889-023-15793-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 04/25/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The Inner Santiago Health Study (ISHS) aimed to (i) estimate the prevalence of common mental disorders (CMD; i.e. depressive and anxiety disorders) among immigrants of Peruvian origin in Chile; (ii) determine whether such immigrants are at higher risk of CMD when compared with the native-born geographically matched population (i.e. non-immigrants); and (iii) identify factors associated with higher risk of any CMD among this immigrant group. A secondary aim was to describe access to mental health services by Peruvian immigrants meeting criteria for any CMD. METHODS Findings are based on a population-based cross-sectional household mental health survey of 608 immigrant and 656 non-immigrant adults (18-64 years) residing in Santiago de Chile. Diagnoses of ICD-10 depressive and anxiety disorders and of any CMD were obtained using the Revised Clinical Interview Schedule. The relationships between demographic, economic, psychosocial, and migration-specific predictor variables, and risk of any CMD were analyzed with a series of stepwise multivariate logistic regression models. RESULTS The one-week prevalence of any CMD was 29.1% (95% CI: 25.2-33.1) among immigrants and 34.7% (95% CI: 30.7-38.7) among non-immigrants. Depending on the statistical model used in the pooled sample, we found the prevalence of any CMD among non-immigrants to be higher (OR=1.53; 95% CI: 1.05-2.25) or similar (OR=1.34; 95% CI: 0.94-19.2) when compared with immigrants. In the multivariate stepwise regression of any CMD in immigrants only, the prevalence was higher for females, those with primary compared to higher education, in debt and exposed to discrimination. Conversely, higher levels of functional social support, sense of comprehensibility, and manageability were associated with a lower risk of any CMD in immigrants. In addition, no differences were observed between immigrants and non-immigrants reporting any CMD in mental health service utilization. CONCLUSION Our results evidence high levels of current CMD in this immigrant group, particularly amongst women. However, lower adjusted prevalence of any CMD in immigrants compared to non-immigrants was limited to preliminary statistical models, thus failing to provide clear support for a "healthy immigrant effect". The study sheds new light on differences in CMD prevalence by immigrant status in Latin America by examining differential exposure to risk factors in immigrant versus non-immigrant groups.
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Affiliation(s)
- Antonia Errazuriz
- Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Santiago, 8330077 Chile
| | - Kristin Schmidt
- Department of Psychiatry and Mental Health, University of Concepción, Concepción, Chile
| | | | | | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- NIHR Applied Research Collaboration East of England, Cambridge, UK
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16
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Herati H, Meyer SB. Mental health interventions for immigrant-refugee children and youth living in Canada: a scoping review and way forward. J Ment Health 2023; 32:276-289. [PMID: 32915669 DOI: 10.1080/09638237.2020.1818710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Traumatic life events experienced by immigrant-refugee children and youth may deteriorate their mental health and well-being. It is a public health priority to develop appropriate mental health interventions for this population. AIMS To understand the psychosocial needs of immigrant-refugee children and youth resettled in Canada in the context of their school and community and to identify the characteristics of school-/community-based mental health programs for this group. METHOD Arksey and O'Malley's methodology for scoping reviews was used to select the studies based on criteria, extract data in a table, and synthesize main findings. RESULTS Fifteen peer-reviewed articles and five grey literature were identified. Key findings show that collaboration between schools, communities, and families play a crucial role in developing and implementing comprehensive mental health interventions for immigrant-refugee children/youth. Involving cultural brokers/interpreters and racially diverse school teachers/staff, is important to establish a trustful relationship between school authorities and marginalized population. CONCLUSIONS Further research is needed to examine the impact of collaborative mental healthcare among multiracial and newcomer families in Canada. Furthermore, there is a need to study the impact of adopting creative expression programs at schools/communities to improve emotional/behavioural problems and enhance school performance of these groups.
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Affiliation(s)
- Hoda Herati
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Samantha B Meyer
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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L'amnésie dissociative dans le Trouble de Stress Post-Traumatique: analyse de la validité scientifique d'un phénomène psychologique controversé. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2023. [DOI: 10.1016/j.ejtd.2023.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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18
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Whittaker S, Martinez I, Kershaw T. Disparities in healthcare utilization and depression among young mothers: The role of family functioning. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231199039. [PMID: 37772936 PMCID: PMC10542225 DOI: 10.1177/17455057231199039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/16/2023] [Accepted: 08/15/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Extant research suggests that disparities in healthcare utilization and experiences of mental health disorders such as depression exist across sociodemographic groups. One understudied pathway that may have significant implications for these disparities is the role of family functioning. How families interact, communicate, and adapt may vary, but these relationships remain integral for vulnerable subsets of the population due to their seemingly protective properties. Yet, few studies have examined the relationship between family functioning and health. OBJECTIVE The aim of this study was to explore family functioning as a predictor for healthcare utilization and depression among young mothers and as a moderator of disparities for each of these outcomes. DESIGN/METHODS This analysis uses data from a prospective cohort study which was conducted with 296 pregnant young women recruited from obstetrics clinics in Connecticut between July 2007 and February 2011 and followed 1-year postpartum. Logistic regression models were used to assess family functioning, race/ethnicity, and immigrant status as predictors of healthcare utilization and depression. Family functioning was evaluated as a moderator for both outcomes. RESULTS Black and Latina mothers had decreased odds of using physical healthcare services (odds ratioBlack = 0.13, p < 0.001; odds ratioLatina = 0.31, p = 0.02). Family functioning was associated with decreased odds of using mental healthcare services (odds ratio = 0.97, p = 0.04) and had a protective effect against depression (odds ratio = 0.96, p = 0.003). Family functioning significantly moderated the relationship between immigrant status and physical healthcare utilization, Black race/ethnicity and physical healthcare utilization, and Other race/ethnicity and depression. CONCLUSION Family functioning is a significant factor associated with both healthcare utilization and depression among young mothers. It should be a strongly considered component within healthcare settings to mitigate risks among vulnerable populations.
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Affiliation(s)
- Shannon Whittaker
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Isabel Martinez
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
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19
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Njie GJ, Khan A. Prevalence of Tuberculosis and Mental Disorders Comorbidity: A Systematic Review and Meta-analysis. J Immigr Minor Health 2022; 24:1550-1556. [PMID: 34796457 PMCID: PMC9114162 DOI: 10.1007/s10903-021-01312-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Persons with tuberculosis (TB) also often have a mental disorder (MD). We examined TB-MD comorbidity prevalence and its impact on TB treatment outcomes as reported in studies set in the United States or in the top five countries of origin (Mexico, the Philippines, India, Vietnam, and China) for non-US-born persons with TB. We searched MEDLINE, EMBASE, OVID, PsycINFO, CINAHL, and Scopus for articles published from database inception through September 2018. Of the 9 studies analyzed, one was set in the United States. The estimated pooled prevalence of comorbid TB-MD from eight non-US studies, with 2921 participants, was 34.0% [95% confidence interval (CI) 21.1%-49.5%]. Comorbid TB-MD prevalence varied by country in the studies evaluated. Additional research might elucidate the extent of TB-MD in the United States and the top five countries of origin.
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Affiliation(s)
- Gibril J Njie
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop US12-4, Atlanta, GA, 30329-4027, USA.
| | - Awal Khan
- Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop US12-4, Atlanta, GA, 30329-4027, USA
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20
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Shuman S, Pollitt AM, O'Brien M, Ibrahim J, Gupta J. Health Correlates of Intimate Partner Violence and Help-seeking Among Unauthorized Immigrant Women. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15620-NP15648. [PMID: 34076546 PMCID: PMC10812846 DOI: 10.1177/08862605211020981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) research on immigrant women who are unauthorized is particularly scarce, despite unique vulnerabilities associated with their documentation status that may impact help-seeking and health outcomes. The purpose of this study was to document the frequency of lifetime IPV and related help-seeking behaviors, and examine the relationship between IPV, major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and health-related quality of life (HRQL) among a community health center-based sample of unauthorized, Spanish-speaking immigrant women in Philadelphia. A clinic-based sample of unauthorized Spanish-speaking women (N = 200, ages 18-65) completed an anonymous, cross-sectional survey on IPV experiences, help-seeking behaviors, and self-reported health in 2013-2014. Chi-square tests assessed associations between sociodemographic variables and IPV. Multivariable logistic regression investigated whether IPV predicted mental health outcomes. Approximately one in three (34.5%) women reported lifetime IPV experiences. Of these, half (56.6%) sought help (formal n = 22; informal n = 25) because of the violence. Women identified not knowing where to go, believing that help was not necessary, and embarrassment as barriers to help-seeking. Symptoms consistent with MDD and PTSD were reported by 40.5% and 16% of the sample, respectively. In unadjusted logistic regression models, IPV survivors were more likely to endorse MDD and PTSD, and report low mental health HRQL scores than counterparts without IPV. In fully adjusted models, only the association between IPV and PTSD remained significant (OR: 3.80, p =.01). Study findings document high frequencies of IPV, MDD, and PTSD among this clinic-based sample of unauthorized immigrant women. Women who reported IPV also had a greater likelihood of reporting symptoms consistent with PTSD. Findings highlight the need for clinic-based mental health and trauma-informed services tailored to unauthorized immigrant women as well as interventions to decrease IPV.
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Affiliation(s)
- Sara Shuman
- Northern Arizona University, Flagstaff, AZ, USA
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Age at Arrival and Depression among Mexican Immigrant Women in Alabama: The Moderating Role of Culture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095342. [PMID: 35564737 PMCID: PMC9103432 DOI: 10.3390/ijerph19095342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/10/2022]
Abstract
Mexican-born women in the U.S. are at high risk of depression. While acculturation is the primary analytical framework used to study immigrant mental health, this research suffers from (1) a lack of specificity regarding how cultural models of living and being take shape among migrants converging in new destinations in the U.S., and (2) methods to empirically capture the impact of cultural positioning on individual health outcomes. Instead of relying on proxy measures of age at arrival and time in the U.S. to indicate where an individual is located on the acculturation spectrum, this study uses cultural consensus analysis to derive the substance and structure of a cultural model for la buena vida (the good life) among Mexican immigrant women in Birmingham, Alabama, and then assesses the extent to which respondents are aligned with the model in their everyday lives. This measure of 'cultural consonance' is explored as a moderating variable between age at arrival in the U.S. and number of depressive symptoms. Results demonstrate that for those who arrived at an older age, those with lower consonance are at the highest risk for depression, while those who are more aligned with la buena vida are at lower risk.
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22
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Tilley JL, Huey SJ, Farver JM, Lai MHC, Wang CX. The Immigrant Paradox in the Problem Behaviors of Youth in the United States: A Meta-analysis. Child Dev 2021; 92:502-516. [PMID: 33528841 DOI: 10.1111/cdev.13542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This meta-analysis synthesizes the empirical data on problem behaviors among foreign- (G1) and U.S-born (G2+) youth and explores the effects of immigrant status on youth internalizing and externalizing problems. A random effects meta-regression with robust variance estimates summarized effect sizes for internalizing and externalizing problems across 91 studies (N = 179,315, Mage = 13.98). Results indicated that G1 youth reported significantly more internalizing problems (g = .06), and fewer externalizing problems than G2+ youth (g = -.06). Gender and sample type moderated the effects. The findings provide a first-step toward reconciling mixed support for the immigrant paradox by identifying for whom and under what conditions the immigrant experience serves as a risk or protective factor for youth.
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Ekeberg KA, Abebe DS. Mental disorders among young adults of immigrant background: a nationwide register study in Norway. Soc Psychiatry Psychiatr Epidemiol 2021; 56:953-962. [PMID: 33156357 PMCID: PMC8192316 DOI: 10.1007/s00127-020-01980-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/24/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Previous research indicates increased risk of various mental disorders in immigrant populations, particularly for schizophrenia and PTSD. However, findings are inconclusive due to variations in contextual factors, characteristics of immigrant groups and study design. Our study aims to investigate prevalence differences of receiving an ICD-10 psychiatric diagnosis between 2008 and 2016 among four first-generation immigrant groups and one second-generation immigrant group compared to ethnic Norwegians. METHODS Linked register data from the Norwegian Patient Registry and Statistics Norway were utilised. The sample (age 18-35) comprises 758,774 ethnic Norwegians, 61,124 immigrants originating from Poland, Somalia, Iran and Pakistan and 4630 s-generation Pakistani immigrants. Age- and gender-adjusted binary logistic regression models were applied. RESULTS The odds of schizophrenia were significantly elevated for all groups except for Poles. The highest odds were observed for second-generation Pakistani immigrants (adjusted OR 2.72, 95% CI 2.21-3.35). For PTSD, the odds were significantly increased for Somalis (aOR 1.31, 95% CI 1.11-1.54), second-generation Pakistani immigrants (aOR 1.37, 95% CI 1.11-1.70), and in particular for Iranians (aOR 3.99, 95% CI 3.51-4.54). While Iranians showed similar or higher odds of receiving the vast majority of psychiatric diagnoses, the remaining groups showed lower or similar odds compared to ethnic Norwegians. CONCLUSION Our findings suggest considerable prevalence differences in receiving a psychiatric diagnosis according to country of origin and generational status compared to ethnic Norwegian controls. The general pattern was lower prevalence of most ICD-10 mental disorders for the majority of immigrant groups compared to ethnic Norwegians, except for schizophrenia and PTSD.
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Affiliation(s)
| | - Dawit Shawel Abebe
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway ,grid.412929.50000 0004 0627 386XNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
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Trombello JM, South C, Sánchez A, Kahalnik F, Kennard BD, Trivedi MH. Two Trajectories of Depressive Symptom Reduction Throughout Behavioral Activation Teletherapy Among Underserved, Ethnically Diverse, Primary Care Patients: A VitalSign 6 Report. Behav Ther 2020; 51:958-971. [PMID: 33051037 DOI: 10.1016/j.beth.2020.01.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/03/2020] [Accepted: 01/05/2020] [Indexed: 12/27/2022]
Abstract
While prior research has investigated trajectories of depressive symptom change throughout psychotherapy, such work has not been conducted exclusively among underserved patients receiving brief Behavioral Activation (BA) teletherapy, intervention modifications that should reduce barriers to therapy initiation and engagement. The current project used cluster analysis to determine discrete groups of symptom change among patients receiving an 8-session BA teletherapy intervention, and analyzed whether demographic and clinical characteristics were associated with group membership. Data from 105 patients referred from charity primary care clinics and receiving at least two therapy sessions were analyzed. Patients were predominantly female and Latina. The 9-item Patient Health Questionnaire (PHQ-9) was the outcome. Two categories were determined: a larger group (N = 61) demonstrating initially less severe symptoms and experiencing a gradual recovery, and a smaller group beginning with more severe symptoms, and experiencing a steeper recovery. In both groups, a majority of participants experienced at least a 5-point drop in depressive symptoms, while in the latter group, a majority of patients achieved depressive symptom remission (PHQ-9 < 5). Monolingual Spanish speakers were more likely to be in the former group, but no other demographic or clinical characteristics were associated with group membership. In both groups, a majority of the symptom reduction occurred by sessions 4-6. Therefore, two categories of depressive symptom change, slow responders and rapid responders, occur among patients receiving a brief BA teletherapy intervention. No demographic differences aside from primary language, nor any clinical characteristics, distinguish group membership, suggesting similar patterns of symptom reduction among a primarily underserved sample.
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A randomised test of the effect of medical v. lay idiom on assessment of perceived mental health condition in the USA. Epidemiol Psychiatr Sci 2020; 29:e172. [PMID: 33028455 PMCID: PMC7576519 DOI: 10.1017/s2045796020000840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS To test the impact of using different idioms in epidemiological interviews on the prevalence and correlates of poor mental health and mental health service use. METHODS We conducted a randomised methodological experiment in a nationally representative sample of the US adult population, comparing a lay idiom, which asked about 'problems with your emotions or nerves' with a more medical idiom, which asked about 'problems with your mental health'. Differences across study arms in the associations of endorsement of problems with the Kessler-6 (a validated assessment of psychological distress), demographic characteristics, self-rated health and mental health service use were examined. RESULTS Respondents were about half as likely to endorse a problem when asked with the more medical idiom (18.1%) than when asked with the lay idiom (35.1%). The medical idiom had a significantly larger area under the ROC curve when compared against a validated measure of psychological distress than the lay idiom (0.91 v. 0.87, p = 0.012). The proportion of the population who endorsed a problem but did not receive treatment in the past year was less than half as large for the medical idiom (7.90%) than for the lay idiom (20.94%). Endorsement of problems differed in its associations with age, sex, race/ethnicity and self-rated health depending on the question idiom. For instance, the odds of endorsing problems were threefold higher in the youngest than the oldest age group when the medical idiom was used (OR = 3.07; 95% CI 1.47-6.41) but did not differ across age groups when the lay idiom was used (OR = 0.76; 95% CI 0.43-1.36). CONCLUSION Choice of idiom in epidemiological questionnaires can affect the apparent correlates of poor mental health and service use. Cultural change within populations over time may require changes in instrument wording to maintain consistency in epidemiological measurement of psychiatric conditions.
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Nwoke CN, Okpalauwaekwe U, Bwala H. Mental Health Professional Consultations and the Prevalence of Mood and Anxiety Disorders Among Immigrants: Multilevel Analysis of the Canadian Community Health Survey. JMIR Ment Health 2020; 7:e19168. [PMID: 32801115 PMCID: PMC7531870 DOI: 10.2196/19168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/20/2020] [Accepted: 08/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is a significant body of evidence on the link between migration and mental health stressors. However, there has been very little research on the use of mental health services by immigrants in Canada. The prevalence of mental health professional consultations among immigrants, as well as its correlations, are not well understood and remain largely unknown. OBJECTIVE This study aims to examine how specialist mental health visits (to a psychiatrist) differ from general mental health visits (to a family doctor or general practitioner) from immigrants, when compared to visits from those born in Canada, in a nationally representative sample of Canadian adults. This study also examines which group-immigrant or Canadian-born-suffers more from depression or anxiety, 2 of the more common mental health conditions. METHODS We used data from the Canadian Community Health Survey (CCHS) between the years 2015 and 2016. The outcome variables included consultation with any mental health professional, consultation with a specialist (psychiatrist), and the prevalence of mood and anxiety disorders. The independent variable was immigrant status. Other variables of interest were adjusted for in the analyses. Multilevel regression models were developed, and all analyses were performed with Stata IC statistical software (version 13.0, StataCorp). RESULTS The prevalence of mood and anxiety disorders was significantly lower among immigrants compared with individuals born in Canada; the prevalence of mood disorders was 5.24% (389,164/7,422,773) for immigrants vs. 9.15% (2,001,829/21,885,625) for individuals born in Canada, and the prevalence of anxiety disorders was 4.47% (330,937/7,410,437) for immigrants vs. 9.51% (2,083,155/21,898,839) for individuals born in Canada. It is expected that individuals with a lower prevalence of mood or anxiety disorders would use mental health services less frequently. However, results show that immigrants, while less likely to consult with any mental health professional (OR=0.80, 95% CI 0.72-0.88, P<.001), were more likely to consult with a psychiatrist (OR=1.24, 95% CI 1.04-1.48, P=.02) for their mental health visits when compared to individuals born in Canada. CONCLUSIONS The results of this study reveal an unusual discord between the likelihood of mental health professional consultations with any mental health professional and mental health visits with psychiatrists among immigrants compared to nonimmigrants in Canada. Mental health initiatives need to be cognizant of the differences in the associated characteristics of consultations for immigrants to better tailor mental health services to be responsive to the unique needs of immigrant populations in Canada.
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Affiliation(s)
| | - Udoka Okpalauwaekwe
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Hauwa Bwala
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Hunter P. Public Health struggles to square hygiene with diversity: Research on the link between microbiomes and immune function puts the "hygiene hypothesis" to rest. EMBO Rep 2020; 21:e51540. [PMID: 32881331 DOI: 10.15252/embr.202051540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The 'Hygiene Hypothesis' to explain the rise in allergies is being replaced by a more nuanced picture of how the immune system interacts with environmental microbes.
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Salas-Wright CP, Vaughn MG, Goings TC, Oh S, Delva J, Cohen M, Schwartz SJ. Trends and mental health correlates of discrimination among Latin American and Asian immigrants in the United States. Soc Psychiatry Psychiatr Epidemiol 2020; 55:477-486. [PMID: 31811317 DOI: 10.1007/s00127-019-01811-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To examine the national trends and mental health correlates of discrimination among Latin American and Asian immigrants in the United States. METHODS We examine data from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2013. Recurrent discrimination was measured by respondent reports of adverse experiences such as receiving poor treatment in restaurants or being called a racist name. RESULTS Rates of perceived discrimination increased by more than 80 percent among immigrants from Latin America (from 14% in 2004 to 25% in 2013), but remained unchanged among Asian immigrants (20-22%). Large percentage point (pp) increases were observed among Latin American immigrants with less than a high school education (pp increase = 13.5) and residing in households earning $20-35,000 annually (pp increase = 14.0). CONCLUSIONS Findings raise concern both because of the inherent iniquitousness of discrimination and because identity-based mistreatment is linked with mental health problems.
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Affiliation(s)
- Christopher P Salas-Wright
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA. .,Department of Public Health Sciences, Division of Prevention Science and Community Health, University of Miami, Miami, FL, USA.
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Trenette Clark Goings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sehun Oh
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Jorge Delva
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Mariana Cohen
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Seth J Schwartz
- Department of Public Health Sciences, Division of Prevention Science and Community Health, University of Miami, Miami, FL, USA
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Honkaniemi H, Juárez SP, Katikireddi SV, Rostila M. Psychological distress by age at migration and duration of residence in Sweden. Soc Sci Med 2020; 250:112869. [PMID: 32120203 PMCID: PMC8325349 DOI: 10.1016/j.socscimed.2020.112869] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/02/2019] [Accepted: 02/18/2020] [Indexed: 11/24/2022]
Abstract
Migrants suffer from worse psychological health than natives in many countries, yet the extent to which this varies by age at migration and duration of residence in the receiving context remains unexplored in Sweden. Drawing on a life course approach, we investigate differences in psychological distress by age at migration and duration of residence in working-age migrants to Sweden, and examine the role of various social determinants of health in explaining these differences relative to Swedish-born. Using pooled cross-sectional data from the 2011/2015 Health on Equal Terms survey in Västra Götaland Region, Sweden (n = 58,428), we applied logistic regression analysis to calculate predicted probabilities and average marginal effects (AME) of migrant status, by age at migration and duration of residence, on psychological distress. Analyses were stratified by sex and region of origin and controlled for indicators of socioeconomic status (SES), social cohesion, and discrimination to assess their potential contribution to differences in migrants' and natives' psychological distress. All migrants except men from OECD-predominant regions had a greater probability of psychological distress than Swedish-born (ranging from AME 0.031 [95% Confidence Interval or CI 0.000-0.062] for OECD women to AME 0.115 [95% CI 0.074-0.156] for non-OECD men). Marginal effects of migration status on psychological distress probabilities generally increased with age at migration and duration of residence. Differences between migrants and natives were largely attenuated after controlling for social determinants, the greatest contribution coming from inequalities in social cohesion, followed by inequalities in discrimination and SES. Our results suggest a relative health advantage of early-life compared to later-life migration, albeit with worse outcomes with longer residence in Sweden. The predominance of integration opportunities in childhood strengthens calls for supportive policies to assist older migrants' integration directly upon arrival, which may ultimately improve their psychological wellbeing.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
| | - Sol Pía Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | | | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Cano M, Takeuchi DT. Recent/Childhood Adversities and Mental Disorders Among US Immigrants. Front Psychiatry 2020; 11:573410. [PMID: 33312137 PMCID: PMC7703683 DOI: 10.3389/fpsyt.2020.573410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022] Open
Abstract
Past research documents the heterogeneity in US immigrants, particularly in terms of racial and ethnic categories and specific ethnic subgroups. The present study builds on this research foundation by investigating heterogeneity in immigrants' experiences of adversity, both recent and during childhood, and associations with mental disorders. Data are drawn from 6,131 adult immigrants in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Prevalence estimates for mental disorders and adversities were calculated overall and by gender. Latent class analysis was utilized to characterize patterns of self-reported experiences of childhood and recent adversities, and multinomial logistic regression established the statistical association between latent class membership and past-year mental disorder outcomes (substance use disorder only, mood/anxiety/trauma disorder only, co-occurring disorder, or no mental disorder). Neglect was the most commonly-reported childhood adversity among immigrant men and women. Prevalence of meeting criteria for a substance use disorder only, or a mood/anxiety/trauma disorder only, varied between men and women, yet no gender differences were observed in prevalence of co-occurring disorders. For latent class analyses, a five-class solution was selected based on fit indices and parsimony. Approximately 10.0% of the sample was categorized in the latent class characterized by severe childhood adversities, while 57.5% was classified in the latent class with low probabilities of reported adversities. The relative risk of meeting criteria for a past-year substance use disorder only (compared to no substance use or mood/anxiety/trauma disorder) was more than three times as high for members of the class with severe childhood adversities (RRR, 3.26; 95% CI, 2.08-5.10), as well as the class with recent employment/financial adversities (RRR, 3.82; 95% CI, 2.36-6.19), compared to the class with low adversities. The relative risk of past-year co-occurring disorders (compared to no disorder) was more than 12 times as high for those in the severe childhood adversities class (RRR, 12.21; 95% CI, 7.06-21.10), compared to the class with low adversities. Findings underscore the importance of considering both recent and childhood adversities when assessing and providing services for US immigrant groups.
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Affiliation(s)
- Manuel Cano
- Department of Social Work, University of Texas at San Antonio, San Antonio, TX, United States
| | - David T Takeuchi
- School of Social Work, University of Washington, Seattle, WA, United States.,Department of Sociology, University of Washington, Seattle, WA, United States
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Breslau J, Wong EC, Burnam MA, McBain RK, Cefalu M, Beckman R, Collins R. Distress, Impairment, and Racial/Ethnic Differences in Perceived Need for Mental Health Treatment in a Nationally Representative Sample. Psychiatry 2020; 83:149-160. [PMID: 32808907 PMCID: PMC7439285 DOI: 10.1080/00332747.2020.1762394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To advance our understanding of racial/ethnic differences in help seeking for mental health conditions, this article tests whether differences in serious psychological distress or functional impairment account for racial/ethnic differences in perceived need for treatment. METHOD Data from the 2009-2014 National Survey of Drug Use and Health, a survey of a nationally representative sample of the U.S. population, were analyzed. Logistic regression models were used to test whether differences in psychological distress, assessed with the Kessler-6, or functional impairment, assessed with the WHO Disability Assessment Scale, account for racial/ethnic differences in perceived need for mental health treatment. RESULTS Perceived need, psychological distress, and functional impairment all vary significantly across racial/ethnic groups; psychological distress is highest among Hispanics interviewed in English and lowest among Hispanics interviewed in Spanish, while functional impairment is highest among Non-Hispanic Whites and lowest among Hispanics interviewed in Spanish. Associations with perceived need vary across racial/ethnic groups for distress (X2 (5) = 22.14, p = .001), but not for impairment (X2 (5) = 8.73, p = .121). Associations between distress and perceived need are significantly weaker among Hispanics interviewed in Spanish than among Non-Hispanic Whites (OR = 1.13 vs. 1.08, p = .001). Differences across racial/ethnic groups in perceived need are sustained after adjustment for distress and impairment. CONCLUSIONS Differences in perceived need across racial/ethnic groups are not attributable to differences in distress and impairment. Heterogeneity in the relationships of psychological distress and functional impairment with perceived need for mental health treatment is related to language, a strong indicator of country of birth.
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Affiliation(s)
- Joshua Breslau
- RAND Corporation, Pittsburgh, Pennsylvania, USA,Corresponding Author: RAND Corporation, 4570 Fifth Avenue, Pittsburgh, PA 15213 412- 683-2300 x4420
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Abdul-Malak Y. Healthy Immigrants? Exploring Depressive Symptoms Among Caribbean and Mexican Immigrants. J Racial Ethn Health Disparities 2019; 7:488-497. [PMID: 31834600 DOI: 10.1007/s40615-019-00677-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/01/2019] [Accepted: 11/28/2019] [Indexed: 11/27/2022]
Abstract
Are there disparities in depressive symptoms among immigrant groups from different countries? With data from the New Immigrant Survey (2003), which includes immigrants from Mexico, Haiti, Dominican Republic, Cuba, and Jamaica, this paper examines the odds of depressive symptoms using a series of logistic regression analyses. It draws on segmented assimilation and the cumulative inequality theories to understand and explicate the extent to which immigrants' demographic characteristics, pre-immigration experiences, and acculturation in the USA might have an impact on immigrants' mental health outcomes. Being from Haiti; Dominican Republic; Cuba; and a woman, with unfavorable childhood health, and migrated at an early age were statistically significant predictors of depressive symptoms. Compared to Mexican immigrants, Cuban and Dominican immigrants reported higher odds of depressive symptoms, controlling for gender, age, education, and pre-immigration experiences. By contrast, Haitian and Jamaican immigrants reported lower odds of depressive symptoms. Female immigrants had higher odds of reporting depressive symptoms compared to their male counterparts. Relative to immigrants with good childhood health, those with unfavorable childhood health had higher odds of reporting worse health outcomes. In the logistic regression models, immigrants who migrated at older age reported lower odds of depressive symptoms. By shedding light on the health status of understudied Caribbean immigrant groups in comparison with Mexican immigrants, this study challenges the healthy migrant effect and serves as a starting point to guide policies that aim at decreasing health disparities among different immigrant groups.
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Vásquez D, Ponte L, Andrews AR, Garcia E, Terrazas-Carrillo E, Ojeda L, de Arrellano MA. Más allá de las barreras: Competency and practice considerations in language, cultural, and social issues when delivering group CPT to Hispanic immigrants. Int J Group Psychother 2019; 70:212-243. [PMID: 32616960 PMCID: PMC7332161 DOI: 10.1080/00207284.2019.1677469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
High rates of under-assessed trauma and psychiatric disorders, particularly posttraumatic stress disorder (PTSD) have been reported among Hispanic immigrants, especially as related to immigration trauma. Multiple studies have shown group cognitive processing therapy (CPT) to be an effective evidence-based practice (EBP) for treatment of PTSD across a number of clinical populations. To date, however, no studies have examined important competency and practice issues in linguistic, cultural, and ethical areas that group CPT providers should consider when delivering group CPT to Hispanic immigrants. This paper aims to outline these and provide future directions for research.
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García C, Garcia MA, Chiu CT, Rivera FI, Raji M. Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans. THE GERONTOLOGIST 2019; 59:877-885. [PMID: 30203062 PMCID: PMC6857755 DOI: 10.1093/geront/gny107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Prior studies examining depression among older Mexican Americans suggest both women and immigrants are at higher risk of depressive symptomatology than males and U.S.-born Mexican Americans. We use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine whether life expectancy with depression and without depression varies by nativity, age of migration, and gender. RESEARCH DESIGN AND METHODS Sullivan-based life tables were used to estimate depression life expectancies among Mexican Americans aged 65 years and older residing in the Southwestern United States. Depression is based on the 20-item Center for Epidemiological Studies Depression scale (CES-D). The CES-D is a continuous scale (0-60) with higher values indicating worse mental health. We dichotomize depression as a score of 16 or greater. RESULTS Immigrant women, particularly those who migrated in late-life (after age 50) are at a significant disadvantage in the number of years after age 65 lived with depression and the ratio of years spent without depression relative to U.S.-born women. Among men, only late-life immigrants were disadvantaged in the number of years spent with depression. Early- and mid-life immigrant males did not differ from U.S.-born males. DISCUSSION AND IMPLICATIONS Our results highlight the heterogeneity among older Mexican Americans in life expectancies with depression. These findings illustrate the importance of considering age of migration as a high-risk factor for depression among Mexican-origin immigrants. Including this risk factor as a part of depression screening is a key step for timely interventions in preventing disability and comorbidities associated with untreated depression.
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Affiliation(s)
- Catherine García
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Marc A Garcia
- Department of Sociology & Institute for Ethnic Studies, University of Nebraska-Lincoln
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | | | - Mukaila Raji
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston
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Edwards J, Hu M, Thind A, Stranges S, Chiu M, Anderson KK. Gaps in Understanding of the Epidemiology of Mood and Anxiety Disorders among Migrant Groups in Canada: A Systematic Review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:595-606. [PMID: 31129987 PMCID: PMC6699028 DOI: 10.1177/0706743719839313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Estimates of mood and anxiety disorders are highly variable among migrant groups, as they are influenced by the socio-political context. Our objective was to conduct a systematic review and meta-analysis to synthesize available Canadian evidence on the prevalence and incidence of mood and anxiety disorders among migrant groups. METHODS Studies were identified from MEDLINE, EMBASE, and PsycINFO. They were included if they used population-based samples, presented data on the incidence or prevalence of diagnosed or self-reported mood or anxiety disorders for first-generation migrant groups in Canada, and used a Canadian-born or long-term resident reference group. RESULTS Nineteen studies met our inclusion criteria. Prevalence ratios ranged from 0.48 to 0.87, and nearly all estimates were obtained from population health surveys. Prevalence estimates among migrant groups were lower than the reference group, with the 90th percentile of estimates ranging from 1.5% to 8.2%. Risk factors for mood and anxiety disorders among migrants included being female, younger, unemployed, having lower income, and living in neighborhoods with a lower proportion of migrants. CONCLUSIONS There remain many gaps in our current understanding of mood and anxiety disorders among migrant groups in Canada. Although evidence suggests the prevalence of mood and anxiety disorders are consistently lower among migrant groups, a lack of incidence estimates limits the strength of this conclusion. Future research should focus on comparisons of self-reported and diagnosed estimates, the use of a range of different primary or secondary data sources, and consideration of important risk factors. PROSPERO CITATION Jordan Edwards, Malini Hu, Amardeep Thind, Saverio Stranges, Maria Chiu, Kelly Anderson. The burden of mood and anxiety disorders among immigrant and refugee populations in Canada: a systematic review. PROSPERO 2018 CRD42018087869 Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087869 .
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Affiliation(s)
- Jordan Edwards
- 1 Department of Epidemiology & Biostatistics, The University of Western Ontario, London Ontario, Canada.,2 Lawson Health Research Institute, London, Ontario Canada
| | - Malini Hu
- 1 Department of Epidemiology & Biostatistics, The University of Western Ontario, London Ontario, Canada
| | - Amardeep Thind
- 1 Department of Epidemiology & Biostatistics, The University of Western Ontario, London Ontario, Canada.,3 Interfaculty Program in Public Health, The University of Western Ontario, London, Ontario, Canada.,4 Department of Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Saverio Stranges
- 1 Department of Epidemiology & Biostatistics, The University of Western Ontario, London Ontario, Canada.,4 Department of Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,5 Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Chiu
- 6 Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Kelly K Anderson
- 1 Department of Epidemiology & Biostatistics, The University of Western Ontario, London Ontario, Canada.,2 Lawson Health Research Institute, London, Ontario Canada.,7 Department of Psychiatry, The University of Western Ontario, London Ontario, Canada
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Salas-Wright CP, Vaughn MG, Miller DP, Hahm HC, Scaramutti C, Cohen M, Delva J, Schwartz SJ. Overeating and binge eating among immigrants in the United States: new terrain for the healthy immigrant hypothesis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1007-1017. [PMID: 30806725 PMCID: PMC6675658 DOI: 10.1007/s00127-019-01677-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/12/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Prior research indicates that, compared to individuals born in the United States (US), immigrants are less likely to experience mental health and inhibitory control problems. However, our understanding of overeating and binge eating-both related to mental health and inhibitory control-among immigrants in the US remains limited. Drawing from a large national study, we report the prevalence of overeating and binge eating among immigrants vis-à-vis the US-born. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS The prevalence of any (immigrants = 7.8%, US-born = 17.0%) and recurrent overeating (immigrants = 2.9%, US-born = 5.3%) was lower among immigrants than US-born individuals. Among those reporting recurrent overeating, the prevalence of binge eating with loss of control was comparable among immigrant (37.2%) and US-born participants (39.9%), in general. However, stratified analyses revealed that risk of binge eating with loss of control was lower among immigrant women compared to US-born women (AOR 0.54, 95% CI 0.29-0.98). CONCLUSIONS Findings from the present study provide clear results that immigrants are substantially less likely to overeat as compared to US-born individuals and that, among women but not men, immigrant status is associated with lower risk of binge eating with loss of control.
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Affiliation(s)
| | - Michael G Vaughn
- School of Social Work, Saint Louis University, St. Louis, MO, USA
- Yonsei University, Seoul, Republic of Korea
| | - Daniel P Miller
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | | | - Mariana Cohen
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Jorge Delva
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Seth J Schwartz
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
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Alvarez K, Fillbrunn M, Greif Green J, Jackson JS, Kessler RC, McLaughlin KA, Sadikova E, Sampson NA, Alegría M. Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults. Soc Psychiatry Psychiatr Epidemiol 2019; 54:553-565. [PMID: 30547212 PMCID: PMC6586416 DOI: 10.1007/s00127-018-1644-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE There has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity. METHODS Survival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys. RESULTS Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent. CONCLUSIONS Parental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences.
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Affiliation(s)
- Kiara Alvarez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, USA. .,Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Mirko Fillbrunn
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Jennifer Greif Green
- Boston University, School of Education, Two Silber Way, Boston, MA 02215, United States
| | - James S. Jackson
- University of Michigan, Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI 48104, United States
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States
| | - Katie A. McLaughlin
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, United States
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA, 02114, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Calzada EJ, Sales A. Depression among Mexican-origin mothers: Exploring the immigrant paradox. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2019; 25:288-298. [PMID: 30372094 PMCID: PMC10460524 DOI: 10.1037/cdp0000214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Residential time in the United States appears to be a risk factor for mental health problems among Latinos, according to studies of the immigrant paradox, or a pattern of findings documenting better health for immigrants relative to U.S.-born Latinos. The present study used an acculturative stress model to examine the immigrant paradox with a sample of Mexican-origin mothers. METHOD Mothers [N = 175; age = 33.52 (10.75)], who were foreign- or U.S.-born, were categorized as more acculturated or less acculturated based on cluster analyses using demographic and language proficiency variables. The association between acculturative status and depressive symptoms approximately 9 months later was tested with two models: with both cultural stressors (i.e., perceived discrimination, acculturative stress) and cultural assets (i.e., familismo, ethnic identity) as mediators, and with the effects of cultural stressors moderated by cultural assets. RESULTS Data provide some support for the validity of the mediation model. Less acculturated mothers reported (a) a stronger ethnic identity, which appears to have protected them from later depression, and (b) stronger familismo, which increased risk for later depression. In addition, discrimination was negatively related to later depression. CONCLUSIONS We found support for the mediating role of cultural assets in the link between acculturation and depression, but some associations were in unexpected directions. These findings highlight the complexities of preserving core cultural characteristics among Mexican-origin mothers living in the United States, and the need to consider the context in which cultural processes unfold. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Esther J Calzada
- Steve Hicks School of Social Work, University of Texas at Austin
| | - Adam Sales
- College of Education, University of Texas at Austin
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Canino G, Shrout PE, NeMoyer A, Vila D, Santiago KM, Garcia P, Quiñones A, Cruz V, Alegria M. A comparison of the prevalence of psychiatric disorders in Puerto Rico with the United States and the Puerto Rican population of the United States. Soc Psychiatry Psychiatr Epidemiol 2019; 54:369-378. [PMID: 30649577 PMCID: PMC6440857 DOI: 10.1007/s00127-019-01653-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/07/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The manuscript compares the rates of psychiatric disorder among island Puerto Ricans, the US population and US Puerto Ricans in order to examine whether social support explains differences in psychiatric disorder among these three groups. METHODS Unadjusted and adjusted rates for sociodemographic factors and social support of main psychiatric disorders are compared among three population-based psychiatric epidemiology studies carried in Puerto Rico (PR) and the United States (US) as part of the NCS-R and NLAAS studies. RESULTS Comparison of adjusted rates showed island Puerto Ricans had similar overall rates of psychiatric disorder as those of the US, lower rates of anxiety disorders, but higher rates of substance use disorders. US Puerto Ricans had higher rates of adjusted anxiety and depression but not of overall psychiatric disorder, as compared to the island. When the rates of disorder were adjusted also for social support, the differences between these two groups disappeared. CONCLUSIONS The findings suggest that social support is a variable worthy of further exploration for explaining differences in disorder prevalence particularly among Puerto Ricans depending on where they live.
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Affiliation(s)
- Glorisa Canino
- Behavioral Sciences Research Institute, Medical School, University of Puerto Rico, Medical Sciences Campus, PO Box 5067, San Juan, PR, 00936-5067, USA.
| | | | - Amanda NeMoyer
- Department of Health Care Policy, Harvard Medical School, Boston, MA,Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Doryliz Vila
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical School, San Juan, PR
| | - Katyana M. Santiago
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical School, San Juan, PR
| | - Pedro Garcia
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical School, San Juan, PR
| | - Amarilis Quiñones
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical School, San Juan, PR
| | - Vilmary Cruz
- Behavioral Sciences Research Institute, University of Puerto Rico, Medical School, San Juan, PR
| | - Margarita Alegria
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
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Bani-Fatemi A, Tasmim S, Graff A, Gerretsen P, Dada OO, Kennedy JL, Hettige N, Zai C, de Jesus D, de Bartolomeis A, De Luca V. The effect of ethnicity and immigration on treatment resistance in schizophrenia. Compr Psychiatry 2019; 89:28-32. [PMID: 30579127 DOI: 10.1016/j.comppsych.2018.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 11/01/2018] [Accepted: 12/05/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Treatment resistance is a common issue among schizophrenia patients undergoing antipsychotic treatment. According to the American Psychiatric Association (APA) guidelines, treatment-resistant status is defined as little or no symptom reduction to at least two antipsychotics at a therapeutic dose for a trial of at least six weeks. The aim of the current study is to determine whether ethnicity and migration are associated with treatment resistance. METHODS In a sample of 251 participants with schizophrenia spectrum disorders, we conducted cross-sectional assessments to collect information regarding self-identified ethnicity, immigration and treatment history. Ancestry was identified using 292 markers overlapping with the HapMap project. Using a regression analysis, we tested whether a history of migration, ethnicity or genetic ancestry were predictive of treatment resistance. RESULTS Our logistic regression model revealed no significant association between immigration (OR = 0.04; 95%CI = 0.35-3.07; p = 0.93) and treatment resistant schizophrenia. White Europeans did not show significant association with resistance status regardless of whether ethnicity was determined by self-report (OR = 1.89; 95%CI = 0.89-4.20; p = 0.105) or genetic analysis (OR = -0.73; 95%CI = -0.18-2.97; p = 0.667). CONCLUSION Neither ethnicity nor migrant status was significantly associated with treatment resistance in this Canadian study. However, these conclusions are limited by the small sample size of our investigation.
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Affiliation(s)
- Ali Bani-Fatemi
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Samia Tasmim
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ariel Graff
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Oluwagbenga O Dada
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - James L Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nuwan Hettige
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Clement Zai
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Danilo de Jesus
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | | | - Vincenzo De Luca
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; University of Naples "Federico II", Naples, Italy.
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Is There a Healthy Immigrant Effect Among Women Through Transnational Marriage? Results from Immigrant Women from Southeast Asian Countries in Taiwan. J Immigr Minor Health 2019; 20:178-187. [PMID: 27743156 DOI: 10.1007/s10903-016-0513-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this study we examine whether there is healthy immigrant effect among women immigrated to Taiwan through transnational marriage. A sample of immigrant women (N = 246) with original nativity of Southeast Asian countries and Taiwanese-born women sample (N = 201) was recruited from December 2008 to December 2009. Their depressive symptoms, acculturative stresses and family functioning were assessed by a series of questionnaires. Immigrant women had lower depressive scores than their native-born counterparts when other potential confounders were controlled for in the multiple regression model. Our findings suggest that the healthy immigrant effect exists among immigrant women in Taiwan. Although such effect may due to immigrant women is a highly selective population with hardy mental characteristics, it is crucial to improve immigrant women's mental health by helping them to enhance the ability of expressing emotions between family members as well as by mitigating socioeconomic inequality of cross-cultural immigrant families.
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Salas-Wright CP, Vaughn MG, Goings TC, Miller DP, Chang J, Schwartz SJ. Alcohol-related problem behaviors among Latin American immigrants in the US. Addict Behav 2018; 87:206-213. [PMID: 30055450 DOI: 10.1016/j.addbeh.2018.06.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care. METHODS The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes. RESULTS Foreign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33-0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32-0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior. CONCLUSIONS Latino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.
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Salas-Wright CP, Vaughn MG, Goings TC, Miller DP, Schwartz SJ. Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis. Psychiatry Res 2018; 267:438-445. [PMID: 29980122 PMCID: PMC6131041 DOI: 10.1016/j.psychres.2018.06.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 05/15/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Despite experiencing migration-related stress and social adversity, immigrants are less likely to experience an array of adverse behavioral and health outcomes. Guided by the healthy migrant hypothesis, which proposes that this paradox can be explained in part by selection effects, we examine the prevalence and comorbidity of mental disorders among immigrants to the United States (US). METHODS Findings are based on the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013), a nationally representative survey of 36,309 adults in the US. RESULTS Immigrants were significantly less likely than US-born individuals to meet criteria for a lifetime disorder (AOR = 0.63, 95% CI = 0.57-0.71) or to report parental history of psychiatric problems. Compared to US-born individuals, the prevalence of mental disorders was not significantly different among individuals who immigrated as children; however, differences were observed for immigrants who arrived as adolescents (ages 12-17) or as adults (age 18+). DISCUSSION Consistent with the healthy migrant hypothesis, immigrants are less likely to come from families with psychiatric problems, and those who migrate after childhood-when selection effects are most likely to be observed-have the lowest levels of psychiatric morbidity.
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Affiliation(s)
- Christopher P. Salas-Wright
- School of Social Work, Boston University, Boston, MA, United States,Corresponding Author: Christopher P. Salas-Wright, 264 Bay State Road, Boston, MA 02215. , Phone: 617-353-3750
| | - Michael G. Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Trenette C. Goings
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel P. Miller
- School of Social Work, Boston University, Boston, MA, United States
| | - Seth J. Schwartz
- Department of Public Health Sciences, Division of Prevention Science & Community Health, University of Miami, Miami, FL, United States
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Georgiades K, Paksarian D, Rudolph KE, Merikangas KR. Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among U.S. Adolescents. J Am Acad Child Adolesc Psychiatry 2018; 57:280-287.e2. [PMID: 29588054 DOI: 10.1016/j.jaac.2018.01.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 01/19/2018] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine differences in lifetime prevalence of mental disorder and service use among U.S. adolescents by both immigrant generation and race/ethnicity. METHOD A total of 6,250 adolescents aged 13 to 18 years in the National Comorbidity Survey Replication Adolescent Supplement were assessed for lifetime prevalence of mood and/or anxiety disorders, behavior disorders, and mental health service use. Twelve groups defined by self-identified race/ethnicity (non-Hispanic white, Hispanic, non-Hispanic black, Asian) and immigrant generation (first, second, third, or more) were compared. RESULTS Differences in prevalence of lifetime mental disorder were most apparent when immigrant generation and race/ethnicity were considered jointly. Compared to third+generation non-Hispanic white adolescents, the odds of mood/anxiety disorder were increased among second-generation Asian (adjusted odds ratio [AOR] = 2.51; 95% CI = 1.22-5.17) and third+generation Hispanic (AOR = 1.28; 95% CI = 1.00-1.63) but reduced among first-generation Asian (AOR = 0.27; 95% CI = 0.10-0.71) and second-generation non-Hispanic white adolescents (AOR = 0.50; 95% CI = 0.30-0.81). The odds of behavior disorder were lower among first-generation Asian (AOR = 0.26; 95% CI = 0.09-0.71) and all generations of non-Hispanic black adolescents (AOR range 0.43-0.55). Adjusting for lifetime disorder, first-generation Hispanic and non-Hispanic white adolescents and all generations of non-Hispanic black adolescents were less likely to receive mental health services (AOR range 0.24-0.55). CONCLUSIONS Variation in risk of disorder by immigrant generation and race/ethnicity underscores the importance of considering social, economic, and cultural influences in etiologic and treatment studies of adolescent psychopathology. Lower rates of service use, particularly among first-generation immigrant adolescents, highlight the need to identify and address barriers to recognition and treatment of mental disorders among adolescents from immigrant and racial/ethnic minority backgrounds.
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Affiliation(s)
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health
| | - Kara E Rudolph
- School of Public Health, University of California, Berkeley
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health.
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Bakhshaie J, Hanna AE, Viana AG, Garza M, Valdivieso J, Ochoa-Perez M, Lemaire C, Cardoso JB, Rogers AH, Mayorga NA, Bogiaizian D, Zvolensky MJ. Acculturative stress and mental health among economically disadvantaged Spanish-speaking Latinos in primary care: The role of anxiety sensitivity. Psychiatry Res 2018; 261:421-427. [PMID: 29353767 DOI: 10.1016/j.psychres.2018.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/22/2017] [Accepted: 01/07/2018] [Indexed: 12/26/2022]
Abstract
The present study examined the role of anxiety sensitivity in the relation between acculturative stress and mood and anxiety symptoms and disorders among Latinos seeking health services at a primary healthcare facility. Participants included 142 adult Latinos (86.6% female, Mage = 39.05 years, SD = 12.46%, and 96.3% reported Spanish as their first language). Results indicated that acculturative stress was indirectly related to the number of mood and anxiety disorders, anxious arousal, social anxiety, and depressive symptoms through anxiety sensitivity. The observed effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and negative affectivity. Overall, the present findings suggest that there is merit in focusing further scientific attention on the interplay between acculturative stress and anxiety sensitivity to better understand and inform interventions to reduce anxiety/depressive vulnerability among Latinos in primary care.
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Affiliation(s)
- Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Abigail E Hanna
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Monica Garza
- Legacy Community Health Services, Houston, TX, United States
| | | | | | - Chad Lemaire
- Legacy Community Health Services, Houston, TX, United States
| | - Jodi Berger Cardoso
- Graduate College of Social Work, University of Houston, Houston, TX, United States
| | - Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Daniel Bogiaizian
- Psychotherapeutic Area of "Asociación Ayuda", Anxiety Disorders Clinic, Buenos Aires, Argentina
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Brunnet AE, Bolaséll LT, Weber JLA, Kristensen CH. Prevalence and factors associated with PTSD, anxiety and depression symptoms in Haitian migrants in southern Brazil. Int J Soc Psychiatry 2018; 64:17-25. [PMID: 29082817 DOI: 10.1177/0020764017737802] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Prevalence rates of mental health disorders in migrants are controversial. The socio-historical and economic background of the host country may play an important role in the mental health status of migrants. As studies are mostly conducted in developed countries, researching migration in developing countries may add important information to scientific literature. AIMS This study aims to investigate the prevalence and factors associated with posttraumatic stress disorder (PTSD), anxiety and depression symptoms in Haitian migrants in southern Brazil. METHODS The sample comprises 66 participants selected from four different sites in three cities of a Brazilian southern state. Participants fulfilled a sociodemographic questionnaire, as well as instruments investigate traumatic events; post-migration difficulties and symptoms of PTSD, anxiety and depression. Linear regression models were utilized to investigate factors associated with PTSD, anxiety and depression symptoms. RESULTS PTSD prevalence in the sample was 9.1%. Depression and anxiety symptoms were in the clinical range of 10.6%-13.6% of participants, respectively. A number of traumatic events, acculturation difficulties, discrimination and low social support were associated with the investigated mental health disorders. CONCLUSION The results point to the importance of public policies in promoting better social and mental health support for migrants. Providing information to the Brazilian population about migration may improve receptiveness in the host society.
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Affiliation(s)
- Alice E Brunnet
- Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura T Bolaséll
- Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - João LA Weber
- Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christian H Kristensen
- Department of Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Salas-Wright CP, Vaughn MG, Clark Goings TT, Córdova D, Schwartz SJ. Substance use disorders among immigrants in the United States: A research update. Addict Behav 2018; 76:169-173. [PMID: 28843730 DOI: 10.1016/j.addbeh.2017.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 07/19/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION There is a critical need for the most current information available on the prevalence of substance use disorders (SUD) among immigrants vis-à-vis that of individuals born in the United States (US). We report the prevalence of SUDs among immigrants from major world regions and top immigrant-sending countries, and assess key moderators (i.e., age, gender, family income, age of migration, time in US) of the relationship between immigrant status and SUD risk. METHOD The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and SUD risk. RESULTS Immigrants were found to be substantially less likely than US-born individuals to be diagnosed with a past-year or lifetime SUD, including alcohol, cannabis, cocaine, and opioid use disorders. These findings held across major world region and among immigrants from the top-ten immigrant sending nations, and across differences in age, gender, family income, age of migration, and time spent in the US. CONCLUSIONS Results from the present study provide up-to-date and cogent evidence that immigrants use alcohol and drugs, and meet criteria for SUDs, at far lower rates than do US-born individuals. Moreover, we provide new evidence that the protective effect of nativity holds for immigrants from an array of global regions and sending countries, and across key demographic and migration-related differences.
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Affiliation(s)
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Trenette T Clark Goings
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - David Córdova
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Seth J Schwartz
- Department of Public Health Sciences, Division of Prevention Science & Community Health, University of Miami, Miami, FL, United States
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Beiser M, Hou F. Predictors of positive mental health among refugees: Results from Canada's General Social Survey. Transcult Psychiatry 2017; 54:675-695. [PMID: 28854860 DOI: 10.1177/1363461517724985] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.
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Salas-Wright CP, Vaughn MG, Goings TC. Immigrants from Mexico experience serious behavioral and psychiatric problems at far lower rates than US-born Americans. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1325-1328. [PMID: 28803401 DOI: 10.1007/s00127-017-1425-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/14/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born. METHODS Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes. RESULTS Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals. CONCLUSION While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.
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Affiliation(s)
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Blvd, St. Louis, MO, 63103, USA
| | - Trenette Clark Goings
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St, Chapel Hill, NC, 27599, USA
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Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds. BMC Psychiatry 2017; 17:264. [PMID: 28724369 PMCID: PMC5517803 DOI: 10.1186/s12888-017-1430-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 07/13/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Acculturation is a long-term, multi-dimensional process occurring when subjects of different cultures stay in continuous contact. Previous studies have suggested that elevated rates of depression among different migrant groups might be due to patterns of acculturation and migration related risk factors. This paper focused on prevalence rates of depressive disorders and related risk factors among individuals with Turkish migration backgrounds. METHODS A population-based sample of 662 individuals with Turkish migration backgrounds were interviewed by bilingual interviewers using a standardised diagnostic interview for DSM-IV-TR and ICD-10 diagnoses (CIDI DIA-X Version 2.8). Associations between 12-month prevalence rates of depressive disorders with potential risk factors were assessed, including gender, age, socioeconomic status, acculturation status and migration status. RESULTS 12-month prevalence rates of any depressive disorder were 29.0%, 14.4% of major depressive disorder (MDD) and 14.7% of dysthymia. Older age and low socioeconomic status were most consistently related to higher risks of depressive disorders. Acculturation status showed associations with subtypes of depressive disorder. Associations differed between men and women. Symptom severity of MDD was linked to gender, with females being more affected by severe symptoms. CONCLUSION The prevalence of depressive disorders is high in individuals with Turkish migration backgrounds, which can be partly explained by older age, low socioeconomic status and acculturation pressures. Only a limited number of risk factors were assessed. Acculturation in particular is a complex process which might not be sufficiently represented by the applied measures. Further risk factors have to be identified in representative samples of this migrant group.
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