Childhood Anxiety in Ethnic Families: Current Status and Future Directions

Parental emotional warmth and identity integration among Chinese migrant adolescents: The role of hope

Literature has established that migration processes have significant effects on the mental and psychological health of migrant children and adolescents. Yet, little is known of the effects of family dynamics and individual characteristics on rural-to-urban migrant adolescents’ psychological adjustment in the context of China. Using a cross-sectional questionnaire-based research design, this article examines the relationship between perceived parental emotional warmth, identity integration and hope among a group of Chinese migrant adolescents. Of a sample of 1,345 Chinese migrant adolescents, between 11 and 19 years old, we found that perceived parental emotional warmth was significantly associated with identity integration, and that hope partially mediated the relationship between parental emotional warmth and identity integration. The implications of the findings for migrant adolescents’ psychological adjustment in receiving communities are discussed.

Migrant status and child and adolescent psychological well-being: evidence from Hong Kong's 'Children of 1997' birth cohort

BACKGROUND

In Western settings, migration is associated with psychological well-being, but studies inevitably focus on culturally distinct ethnic minorities, making it difficult to distinguish migration from cultural assimilation. Many children in Hong Kong, a developed non-Western setting, have migrant parents with the same Chinese ethnicity. This study examined the association of migration with the child's psychological well-being in Hong Kong.

METHODS

Multivariable linear regression was used in Hong Kong's 'Children of 1997' Chinese birth cohort to examine the adjusted associations of migration (both parents Hong Kong born n=4285, both parents migrant n=1921, mother-only migrant n=462, father-only migrant n=1110) with a parent-reported Rutter score for child behaviour at ∼7 (n=6294, 80% follow-up) and ∼11 years (n=5598, 71% follow-up), self-reported Culture-Free Self-Esteem Inventory score at ∼11 years (n=6937, 88% follow-up) and self-reported Patient Health Questionnaire-9 (PHQ-9) depressive symptom score at ∼13 years (n=5797, 73% follow-up), adjusted for sex, highest parental education and occupation, household income, maternal and paternal age at birth, age of assessment and survey mode (PHQ-9 only).

RESULTS

Migration was unrelated to the overall self-esteem or depressive symptoms, but both parents migrant was associated with better behaviour (lower Rutter scores) at ∼7 years (β-coefficient (β) -1.07, 95% CI -1.48 to -0.66) and ∼11 years (-0.89, 95% CI -1.33 to -0.45).

CONCLUSIONS

In a non-Western context, migration appeared to be protective for childhood behaviour.

The FRIENDS emotional health program for minority groups at risk

BACKGROUND

Despite the existence of evidence-based interventions for promoting mental health in children, the number of children at risk remains high. One of the reasons is that such interventions are not reaching specific groups at risk such as low socioeconomic status and ethnic minority groups. This study evaluated an adaptation of a school-based psychosocial program for nonreferred students aged 11 to 12 years attending a multicultural school from a low socioeconomic status area.

METHODS

The FRIENDS Program was adapted for a multicultural population. A quasi-experimental design was used, involving a pre/post-test, to evaluate the impact of the intervention on participants' outcomes on the Strengths and Difficulties Questionnaire (SDQ). Participants were divided into 2 categories ("at risk"/"not at risk") based on their scores in the SDQ at pre-test. Post-test data were collected to evaluate the overall effectiveness and acceptability of the program.

RESULTS

Analyses showed significant improvement for the group initially identified as "at risk," with 30% of the students being no longer at risk after the intervention. Most students rated the intervention as being highly acceptable and useful.

CONCLUSIONS

Adaptations to existing evidence-based programs for implementation with specific minority groups at risk represents a promising approach to promote emotional health in children.

The effects of social connections on self-rated physical and mental health among internal migrant and local adolescents in Shanghai, China

BACKGROUND

China is in the midst of history's largest flow of rural-urban migration in the world; a flow that includes growing numbers of children and adolescents. Their health status is an important public health issue. This study compares self-rated physical and mental health of migrant and local adolescents in China, and examines to what extent layered social connections account for health outcomes.

METHODS

In 2010, we conducted a cross-sectional study among middle school students in Pudong New Area, Shanghai. Information about health status, social connections, and demographic factors were collected using a questionnaire survey. After controlling for sociodemographic factors, we used the t-test, Chi-square analysis, and a series of regression models to compare differences in health outcomes and explore the effects of social connections.

RESULTS

Migrant adolescents reported significantly higher rates of good physical health. However, they also had significantly fewer social connections, lower self-esteem, and higher levels of depression than their native peers. Family cohesion was associated with depressive symptoms and low self-esteem among all adolescents; peer association and social cohesion played major roles in migrants' well-being. Gender, age, and socioeconomic (SES) factors also affected adolescents' self-rated physical and mental health.

CONCLUSIONS

Self-rated data suggest that migrant adolescents enjoy a physical health advantage and a mental health disadvantage. Layered social connections, such as peer association and social cohesion, may be particularly important for migrants. A public health effort is required to improve the health status of migrant youth.

Correlates of psychological wellbeing of children of migrant workers in Shanghai, China

BACKGROUND

It is estimated that approximately 20 million migrant school-aged children have accompanied their parents in relocating to cities in China. However, little research on the lives of these children has been conducted. The purpose of the present study is to identify the risk factors associated with the psychological wellbeing of children of migrant workers in Shanghai, China.

METHODS

A total of 625 children of migrant workers were recruited from ten primary and secondary schools in Shanghai through a survey design using the multistage cluster sampling method. Children of migrant workers were identified as mentally healthy or unhealthy using The revised child anxiety and depression scale. Socio-demographic characteristics, parent-child relationship, peer relationship and relationships in schools were explored as correlates of the psychological wellbeing of children of migrant workers.

RESULTS

Compared to overseas studies, children of migrant workers suffered from symptoms of separation anxiety, depression and generalized anxiety disorder. They were male (OR = 1.88, 95% CI 0.99-3.60), older in age (OR = 1.18, 95% CI 0.99-1.40), experiencing parent-child conflicts (OR = 1.92, 95% CI 1.28-2.89), discipline from teacher (OR = 2.29, 95% CI 1.26-4.16) and discrimination in school (OR = 4.53, 95% CI 1.11-18.48).

CONCLUSION

The findings provide information for the prevention of mental ill-health among children of migrant workers in China. The implications and limitations are also discussed.

Mental health in migrant children

Many factors have been identified to explain differences in mental health problems between migrant and native children: the process of migration, the ethnic minority position of migrants, their specific cultural background and the selection of migrants. In this paper, the international literature regarding mental health of migrant children is reviewed using strict selection criteria. An extensive search was carried out to locate journal articles on the subject of mental health in migrant youth published since the 1990s. Only 20 studies met all inclusion criteria. Besides the conclusion that the studies did not unequivocally find an increased risk of mental health problems in migrant children, it proved to be very difficult to draw any sound conclusions with respect to these children's risk of mental health problems, since the impact of migration on children's mental health varied with the informants used and the characteristics of the migrant group and of the host country. The lack of univocal definitions of key terms further complicated generalised conclusions in this research field. As such, this research field is in urgent need of more research using standardised research designs, methodology and definitions. A proposition for this research design is made.

Prevention of Childhood Emotional Disorders: Reducing the Burden of Suffering Associated with Anxiety and Depression

Anxiety and depression are the most common mental health problems affecting young people today. This review presents a description of the prevalence and impact of these emotional disorders in children and youth. While treatment offers one approach to intervening, research indicates that most sufferers will not actually receive clinical intervention, and of the minority who do, many will terminate prematurely, fail to respond, or experience recurrent difficulties despite treatment. Prevention approaches offer an alternative and adjunct to treatment, and have become a priority for governments, offering a cost effective and efficient means of providing services to children and youth prior to the onset of psychopathology. This review describes current practises in prevention research and provides an overview of an Australian developed cognitive-behavioural programme that has acquired a solid evidence-base as well as popularity in schools as one approach to building emotional resilience in children and youth, whilst effectively reducing the burden associated with emotional disturbances of anxiety and depression. Future directions for prevention practice and research are highlighted.

Comorbidity of PTSD and depression: associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia

BACKGROUND

Posttraumatic stress disorder (PTSD) is common in refugees but its association with longer-term psychosocial dysfunction remains unclear. We examined whether a subgroup of refugees with comorbid PTSD and depression were at particularly high risk of disability. We also investigated whether specific trauma experiences were linked to this comorbid pattern.

METHODS

Consecutive Bosnians (and one or two compatriots nominated by them) were recruited from a community centre, yielding a total sample of 126 participants (response rate 86%). Measures included a trauma inventory, the Clinician Administered PTSD Scale (CAPS) (Blake et al., 1995) and the depression module of the Structured Clinical Interview (SCID) (First et al., 1997).

RESULTS

Three diagnostic groupings emerged: normals (n=39), pure PTSD (n=29), and comorbid PTSD and depression (n=58). Of four trauma dimensions derived from principle components analysis (human rights violations, dispossession and eviction, life threat and traumatic loss), life threat alone was associated with pure PTSD, with life threat and traumatic loss both being associated with comorbidity. Compared to normals and those with pure PTSD, the comorbid group manifested more severe PTSD symptoms as well as higher levels of disability on all indices (global dysfunction: odds ratio=5.0, P<0.001, distress: odds ratio=6.0, P<0.001, social impairment: odds ratio 5.9, P<0.001, and occupational disability: odds ratio 5.0, P<0.001).

LIMITATIONS

Recruitment was not random, the sample size was modest, and trauma event endorsement was based on retrospective accounts.

CONCLUSIONS

The combination of life threat and traumatic loss may be particularly undermining to the psychological well-being of refugees and consequent comorbidity of PTSD and depression may be associated with longer-term psychosocial dysfunction. The findings raise the question whether the comorbid pattern identified should be given more recognition as a core posttraumatic affective disorder.