Racial/ethnic differences in the prevalence of internalizing symptoms: do Latin-American immigrant show more symptomatology than Spanish native-born adolescents?

Emotional and relational problems of adolescents with and without a migrant background in Europe: a systematic review

Mental health of migrant adolescents is a topic that has been widely studied in the past decades. Emotional and behavioural problems are amongst the most explored areas; however, little attention has been paid to the relational sphere, which represents another key aspect of mental health and is paramount during adolescence. This systematic review analysed the available evidence on emotional and relational problems comparing adolescents with and without a migrant background in Europe between 2010 and 2021. The search was conducted in four databases using a common search strategy composed of terms addressing adolescence, migrant population, and emotional and relational problems. Three rounds of screening produced 36 eligible studies. Factors affecting both types of problems were identified and categorised using thematic synthesis, dividing them into factors affecting both types of problems jointly or separately and analysing them according to three systemic levels affecting the adolescents' lives (intrapersonal, interpersonal and external). Critical analysis of the results pointed to mixed findings, with a mild tendency in migrant-background adolescents to portray more emotional problems than their native peers and a stronger tendency for relational problems in the same direction. Several limitations were identified and, along with the conclusions, point to suggestions for future research focusing on studying relational problems as a key component of mental health and its link to emotional problems. Further suggestions entail designing studies that target adolescents with different migrant-background profiles and cultural origins to establish differences between them and identify additional factors affecting emotional and relational problems during the pre-migration and transit phases of the migratory journey to help prevent the onset of these problems.

Depression, Anxiety and Antidepressants and Anxiolytics Use in Spanish Informal Caregivers according to the Physical Activity Frequency: EHSS 2014–2020

Depression and anxiety are two of the most common mental diseases both in formal and nonformal caregivers. Physical activity during leisure time seems to have benefits on their practitioner’s mental health. This study aimed to analyze the associations between physical activity frequency (PAF) and depression and anxiety status, as well as antidepressant and anxiolytic use in Spanish nonformal caregivers. A cross-sectional study with data from the 2014 and 2020 European Health Interview Surveys in Spain (EHSS) including 4520 Spanish nonformal caregivers was carried out. The PAF was found to be related to depression and anxiety, as well as antidepressants and anxiolytics use (p < 0.001), with the highest proportions of these variables found in the inactive population (p < 0.05), while the active and very active populations showed the lowest proportions (p < 0.05). Weak but statistically significant correlations were found between all variables of interest (p < 0.001). Being female, older, and dedicating more hours per week to caregiving and caring for nonfamily members were found to have increased risks of depression, anxiety and antidepressants or anxiolytics use. Nonformal caregivers who were not physically active during their leisure time had higher mental disorders and psychotropic drug use proportions than the active and very active caregivers. Thus, increasing nonformal caregivers’ PAF could be a protective tool.

The Impact of Adverse Childhood Experiences and Community Violence Exposure on a Sample of Anxious, Treatment-Seeking Children

Screening for adverse childhood experiences (ACEs) can help prevent and reduce adverse outcomes on child development, including increased risk for anxiety disorders. Emerging studies strongly support the inclusion of community-level adversities in ACE screeners to consider diverse contexts and populations. Recent studies suggest that community violence exposure (CVE) may have a distinct impact on youth mental health. Although recent studies have examined the association between ACEs, CVE, and mental health in primary care settings, this association has not been examined on treatment-seeking children in urban mental health settings. The present study employs a mediation model using the PROCESS macro to examine community violence exposure mediating the effect on the association between ACEs and somatic symptoms (SS) on a sample of anxious treatment-seeking children. A total of 98 participants (Mage = 11.7, SD = 3.79, 51.6% males, 54.1% ethnic minority children) who sought services at a specialized anxiety clinic completed self-report measures. Results indicated that exposure to ACEs is associated with endorsement of somatic symptoms as a result of reporting hearing, witnessing, or experiencing CVE. Evidence of mediation was found in a statistically significant indirect effect of ACEs on SS through CREV (Effect = .17, 95% CI = .069-.294). These findings support recent evidence that CVE is a distinct ACE as it contributes to toxic stress similar to individual-level ACEs. The use of a comprehensive ACE screening that includes CVE is warranted, particularly when working with culturally and socioeconomically diverse populations, as it would better capture a broader range of adversities across demographic groups.

Patterns of internalizing symptoms and disability functioning in children and adolescents

Despite findings from previous studies, there is still little consistent knowledge regarding the co-occurrence patterns of somatic, depressive and anxiety symptoms in childhood and adolescence. Moreover, functional disability due to somatic symptoms at different concomitant levels of depression and anxiety is understudied. The present study examined the co-occurrence patterns of somatic symptoms and symptoms of depression and anxiety, in children and adolescents using two-step cluster analysis. Differences in functional disability due to somatic symptoms were tested with ANCOVA controlling for gender and age. The sample comprised 1127 Italian children and adolescents (48.7% males, n = 549) aged 8-16 years (M_age = 11.7, SD = 2.37). Data were collected using the Children Somatization Inventory-24, the Children Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the Functional Disability Inventory. A four-cluster solution based on the co-occurrence of internalizing symptoms best fit the data. The four clusters were labelled as follows: cluster 1: "High somatic symptoms and average depression/anxiety"; cluster 2: "High somatic symptoms and high depression/anxiety"; cluster 3: "Average somatic symptoms and above average depression/anxiety"; and cluster 4: "Low somatic symptoms and low depression/anxiety". Significant differences between the four groups according to gender and age were shown. Participants with high levels of somatic, depressive, and anxiety symptoms reported greater functional disability due to somatic symptoms than the other three groups. Our findings indicate that children and adolescents who demonstrate high symptoms of depression and anxiety also reported higher levels of disability in daily life due to somatic symptoms.

Systematic review on somatization in a transcultural context among teenagers and young adults: Focus on the nosography blur

Aims

Somatic complaints are a frequent cause for consultation in primary care. In a transcultural context, somatic complaints are typically associated with psychological distress. A recent review about somatic symptom disorders in adolescence showed some nosographic heterogeneity and outlined various etiological hypotheses (traumatic, environmental, or neurologic), separate from the cross-cultural considerations. Migrants' children encounter specific problems involving cultural mixing-issues of filiation (familial transmission) and affiliation (belonging to a group). This paper aims to provide a systematic review of somatization in transcultural contexts among teenagers and young adults, aged 13 to 24, over the past decade.

Methods

This review adheres to the quality criteria set forth by the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two authors queried three English databases (Medline, PsycInfo, WebOfScience) about somatization in transcultural contexts (migrant or non-Western population) among teenagers (13-18), young adults (19-24), or both. The methodological process comprised articles selection, data extraction, and then the analysis of emerging themes. Setting selection criteria to limit the transcultural field was difficult.

Results

The study analyzed 68 articles. We present a descriptive analysis of the results, centered on three main themes. First, the literature highlights a nosographic muddle reflected in the combination of anxious and depressive symptoms together with the highly variable symptomatology. Second, discrimination issues were prevalent among the migrant population. Lastly, the literature review points out possibilities for improving a care pathway and reducing the diagnostic delay induced by migrants' hesitancy about Western care and the recurrent use of inappropriate diagnostic criteria.

Conclusion

This review discusses the links between the nosographic muddle described here and the diagnostic delays these patients experience and raises concerns about rigid diagnostic compartmentalization. The work of the psychiatrist Frantz Fanon is here useful to understand externalized symptoms resulting from physical and psychological confinement. Discrimination issues raise questions about the cultural counter-transference health professionals experience in dealing with young migrants. Defining healthcare professionals' representations about somatic complaints in a transcultural context might be a fruitful path to explore in future research.

Protocol PROSPERO registration number

CRD42021294132. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021294132.

Parenting Styles, Anxiety and Depressive Symptoms in Child/Adolescent

OBJECTIVE

To analyse the possible direct and interactive associations of sex, age and parenting styles with symptoms of depression and anxiety.

METHODS

In this cross-sectional study, 710 students ranging from 8 to 13 years (mean age 10.8 years [ 0.75]), the most of them males (n = 422, 59.4%), completed three screening instruments: a parenting practices scale and two self-reports for evaluating anxiety and depressive symptoms. Two hierarchical multiple regression analyses were performed.

RESULTS

Authoritative (38.6%) and neglectful (38%) parenting styles were predominant. Symptoms of depression -F (3, 706) = 3.12, p = .03- and anxiety -F (3, 706) = 2.83, p = .4- differed by parenting styles. Students with a neglectful parenting style reported significant lower generalized anxiety symptoms than those whose parents used authoritative parenting.

CLINICAL IMPLICATIONS

Children ages 8 to 13 years-old with authoritative parenting style should be evaluated for possible presence of generalized anxiety symptoms.

Influence of resilience on the relations among acculturative stress, somatization, and anxiety in latinx immigrants

OBJECTIVE

In cultures where psychological distress is stigmatized, the presentation of emotional distress as somatic complaints is a frequent occurrence. Understanding factors that contribute to the presentation of somatization in Latinx immigrants is crucial due to its tie to poor quality of life. The purpose of this study was to explore relations among acculturative stress, anxiety, somatization, and resilience in a sample of Latinx immigrants living in the United States.

METHODS

Data were collected from 204 Latinx immigrants across diverse community settings.

RESULTS

Acculturative stress was positively related to both anxiety and somatization, and the relation between acculturative stress and somatization occurred through anxiety. Resilience moderated the relations between acculturative stress and somatization, and between anxiety and somatization.

CONCLUSION

This study suggests that Latinx immigrants presenting with somatic symptoms may benefit from the examination of a possible comorbid presentation of anxiety or acculturative stressors. An integrated behavioral healthcare approach is recommended when working with Latinx immigrants evaluating the impact of minority stressors on health. Clinicians are encouraged to incorporate cultural protective factors that reinforce the development and sustenance of resilience.

Somatic symptoms in those with performance and interaction anxiety

This study (n = 304) examined the relationship between somatic symptoms and social anxiety. Significant differences in the experience of somatic symptoms were found among four groups (i.e. performance anxious, interaction anxious, generalized socially anxious, and controls). Post hoc analyses revealed that those who exceeded the clinical cutoff for generalized social anxiety exhibited more somatic symptoms than those who exceeded the clinical cutoff in the other two social anxiety domains or controls. Individuals in each group exhibited more somatic symptoms than controls, but subtypes did not differ in the amount of somatic symptoms experienced. Additionally, regression analyses revealed that type of somatic symptoms experienced varied depending on subtype.